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PRIME VISA SOLUTIONS

COMPLETE PRIME VISA USA QUESTIONNAIRE FOR EVALUATION

A. What are your grounds for immigration eg employment, family, business?

B. Do you have a valid job offer in the United States and if so describe the company and the prospective employment?

C. Do you require immigration assistance based on an engagement, marriage or close family relationship to a U.S. Citizen? If yes, please describe:

D. Do you have any other family members currently residing in the United States?

E. YOUR INFORMATION

NAME :

Date of Birth :

Nationality :

Citizen of :

Other names used (including maiden name)

Sex :

Place Of Birth :

U.S. Social Security No.(If Any)

Home Phone :

E-mail address :

Business Phone :

U.S. Address (if any) :

Address Abroad (Home) :

Phone Number Abroad :

Education :

High School :

College :

Degrees earned :

Year(s) Completed Education (University) :

Any professional licenses, certifications, or professional memberships?

Have you ever been in the United States before?

Date/Place of last arrival in U.S. :

Place :

Type of Visa?

How long did you stay in the United States?

Has a prior employment visa petition ever been filed on your behalf?

If YES, then answer the following:

Where
When

Approved?

Means of travel into U.S.

Inspected?

Status at entry (visitor, student)

Consulate Visa Issued

Visa Number

Date Visa Issued

Visa Expiration Date

OR Indefinite (yes/no)

Visa Classification :

What is your Passport No. :

Passport Issue Date :

Passport Expiration Date :

If currently in the U.S., what is your I-94 No. :

I-94 Issue Date :

I-94 Expiration Date :

Duration of Stay :

Name Exactly as it appears on I-94 :

By signing below, you acknowledge that your responses to this questionnaire are true and correct to the best of your knowledge.

Signature :

Print Name :

Place :

Thank You for taking the time to complete our questionnaire. Prime Visa will review your information and contact you to discuss