One Step Family Based Immigration Questionnaire



Law Office of Ning Gan

1625 The Alameda, Suite 800

San Jose, CA 95126

Fax: 408 491 9760

Email: info@

One Step Family Based Immigration Questionnaire 

for US Citizen's Immediate Relatives in the United States

INFORMATION TO BE COMPLETED BY U.S. PETITIONER

Please enter your answers into the shaded column

|INFORMATION ABOUT THE U.S. CITIZEN PETITIONER |

|Last Name | |

|First Name | |

|Full Middle Name | |

|Other Names Used (Maiden): | |

|Sex (Male or Female): | |

|U.S. Address: | |

|Home phone: | |

|Cell Phone | |

|Office phone: | |

|Fax Number: | |

|Email Address: | |

|Date of Birth (mo/day/year): | |

|Place of Birth (City, State/Province, Country): | |

|U.S. Social Security Number: | |

|Alien Registration Number (if any): | |

|Marital Status (circle one): |Married _____ Single ______Widowed______Divorced |

|If Married, Date and Place of Present Marriage: | |

|Names of Prior Husbands/Wives and Date(s) Marriage(s)| |

|Ended: | |

If U.S. Citizen Petitioner petition overseas spouse, please complete the following:

|INFORMATION FOR THE U.S. PETITIONER’S PARENTS |

|INFORMATION ABOUT Father |

|Last Name | |

|First Name | |

|Middle Name | |

|Date of Birth | |

|City & County of Birth | |

|City and Country of Residence | |

|INFORMATION ABOUT MOTHER |

|Maiden Name | |

|First Name | |

|Middle Name | |

|Date of birth | |

|City and Country of birth | |

|City and Country of Residence | |

|INFORMATION ABOUT THE U.S. PETITIONER’S MARRIAGE |

|Current Marriage |

|Name of Spouse | |

|Date of Birth of Spouse | |

|Place of Birth of Spouse | |

|Date and place of marriage | |

|Previous Marriage |

|Name of former Spouse | |

|Date of birth of former Spouse | |

|Place of Birth of former Spouse | |

|Date and Place of Previous Marriage | |

|Date and Place of termination of marriage | |

|INFORMATION ABOUT THE U.S. PETITIONER’S RESIDENCE FOR THE PAST FIVE YEARS |

|Please list current address first |

|Street Address |City |State |From (mon/yr) |To (mon/yr) |

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|INFORMATION ABOUT THE U.S. PETITIONER’S LAST RESIDENCE ABROAD |

|Street Address |City |State |From (mon/yr) |To (mon/yr) |

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|INFORMATION ABOUT THE U.S. PETTIONER’S EMPLOYMENT FOR THE PAST FIVE YEARS |

|Please list current employment first |

|Name and address of employer |From (mon/yr) |To (mon/yr) |

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INFORMATION TO BE COMPLETED BY ALIEN RELATIVE

|INFORMATION ABOUT YOUR ALIEN RELATIVE |

|Last Name | |

|First Name | |

|Full Middle Name | |

|Sex | |

|Current Address | |

|Cell Phone Number | |

|Home Phone Number | |

|Work phone number | |

|Email address | |

|Date of birth | |

|City and Country of birth | |

|Social security number (if any) | |

|Country of Citizenship | |

|Alien registration number (if any) | |

|Date of Most Recent Arrival in the US | |

|Place of Most recent entry into the U.S.(city/state) | |

|Current nonimmigrant status | |

|Expiration date of current nonimmigrant status | |

|Your mother’s first name | |

|Your father’s first name | |

|Nonimmigrant visa number (the red number in the middle of your | |

|visa stamp, not the control number) | |

|Date your visa was issued | |

|Marital Status |Married ___ Single______ Divorced_______ Widow_______ |

|Have you ever before applied for permanent resident status in | |

|the US |Yes ________ No_________ |

|If yes, give date and place of filing and final disposition | |

|List your present and past membership in or affiliation with every political organization, association, fund, foundation, party, club, |

|society, or similar group in the United States or in any other place since your 16th Birth date. Include any foreign military service in this|

|part. If none, write”None”. Include the name of organization, location, dates of membership from and to, and the nature of the organization: |

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|INFORMATION ABOUT SPOUSE AND CHILDREN |

|Spouse |

|Last Name | |

|First Name | |

|Middle Initial | |

|Date of birth: | |

|Country of birth: | |

|Relationship to you | |

|Country of Citizenship | |

|Apply with you |YES______ NO_________ |

|CHILD# 1 |

|Last Name | |

|First Name | |

|Middle Initial | |

|Date of birth: | |

|Country of birth: | |

|Relationship to you | |

|Country of Citizenship | |

|Apply with you |YES______ NO_________ |

|CHILD# 2 |

|Last Name | |

|First Name | |

|Middle Initial | |

|Date of birth: | |

|Country of birth: | |

|Relationship to you | |

|Country of Citizenship | |

|Apply with you |YES______ NO_________ |

|CHILD# 3 |

|Last Name | |

|First Name | |

|Middle Initial | |

|Date of birth: | |

|Country of birth: | |

|Relationship to you | |

|Country of Citizenship | |

|Apply with you |YES______ NO_________ |

|CHILD# 4 |

|Last Name | |

|First Name | |

|Middle Initial | |

|Date of birth: | |

|Country of birth: | |

|Relationship to you | |

|Country of Citizenship | |

|Apply with you |YES______ NO_________ |

|Passport number and expiration date: | |

|INFORMATION FOR THE APPLICANT’S PARENTS |

|INFORMATION ABOUT Father |

|Last Name | |

|First Name | |

|Middle Name | |

|Date of Birth | |

|City & County of Birth | |

|City and Country of Residence | |

|INFORMATION ABOUT MOTHER |

|Maiden Name | |

|First Name | |

|Middle Name | |

|Date of birth | |

|City and Country of birth | |

|City and Country of Residence | |

|INFORMATION ABOUT THE APPLICANT”S MARRIAGE |

|Current Marriage |

|Name of Spouse | |

|Date of Birth of Spouse | |

|Place of Birth of Spouse | |

|Date and place of marriage | |

|Previous Marriage |

|Name of former Spouse | |

|Date of birth of former Spouse | |

|Place of Birth of former Spouse | |

|Date and Place of Previous Marriage | |

|Date and Place of termination of marriage | |

|INFORMATION ABOUT THE APPLICANT”S RESIDENCE FOR THE PAST FIVE YEARS |

|Please list current address first |

|Street Address |City |State |From (mon/yr) |To (mon/yr) |

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|INFORMATION ABOUT THE APPLICANT”S LAST RESIDENCE ABROAD |

|Street Address |City |State |From (mon/yr) |To (mon/yr) |

|INFORMATION ABOUT THE APPLICANT”S EMPLOYMENT FOR THE PAST FIVE YEARS |

|Please list current employment first |

|Name and address of employer |From (mon/yr) |To (mon/yr) |

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|INFORMATION ABOUT THE APPLICANT”S LAST EMPLOYMENT OVERSEAS |

|Name and address of employer |From (mon/yr) |To (mon/yr) |

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Please answer the following questions. (If your answer is "YES" on any one of these questions, explain on a separate piece of paper.

a. Have you ever, in or outside the U.S.:

1. knowingly committed any crime of moral turpitude or a drug-related offense for which you have not been arrested?

2. been arrested, cited, charged, indicted, fined, or imprisoned for breaking or violating any law or ordinance, excluding traffic violations?

3. been the beneficiary of a pardon, amnesty, rehabilitation decree, other act of clemency or similar action?

4. exercised diplomatic immunity to avoid prosecution for a criminal offense in the U.S.?

___ Yes   __ No

b. Have you received public assistance in the U.S. from any source, including the U.S. government or any state, county, city, or municipality (other than emergency medical treatment), or are you likely to receive public assistance in the future?

___ Yes   __ No

c. Have you ever:

1. within the past 10 years been a prostitute or procured anyone for prostitution, or intend to engage in such activities in the future?

2. engaged in any unlawful commercialized vice, including, but not limited to, illegal gambling?

3. knowingly encouraged, induced, assisted, abetted or aided any alien to try to enter the U.S. illegally?

4. illicitly trafficked in any controlled substance, or knowingly assisted, abetted or colluded in the illicit trafficking of any controlled substance?

___ Yes   __ No

d. Have you ever engaged in, conspired to engage in, or do you intend to engage in, or have you ever solicited membership or funds for, or have you through any means ever assisted or provided any type of material support to, any person or organization that has ever engaged or conspired to engage, in sabotage, kidnapping, political assassination, hijacking, or any other form of terrorist activity?

___ Yes   __ No

e. Do you intend to engage in the U.S. in:

1. espionage?

2. any activity a purpose of which is opposition to, or the control or overthrow of, the Government of the U.S., by force, violence or other unlawful means?

3. any activity to violate or evade any law prohibiting the export from the Untied States of goods, technology or sensitive information?

___ Yes   __ No

f. Have you ever been a member of, or in any way affiliated with, the Communist Party or any other totalitarian party?

___ Yes   __ No

g. Did you, during the period March 23, 1933 to May 8, 1945, in association with either the Nazi Government of Germany or any organization or government associated or allied with the Nazi Government of Germany, ever order, incite, assist or otherwise participate in the persecution of any person because of race, religion, nationality, ethnic origin, or political opinion?

___ Yes   __ No

h. Have you ever engaged in genocide, or otherwise ordered, incited, assisted or otherwise participated in the killing of any person because of race, religion, nationality, ethnic origin, or political opinion?

___ Yes   __ No

i. Have you ever been deported from the U.S., or removed from the U.S. at government expense, excluded within the past year, or are you now in exclusion or deportation proceedings?

___ Yes   __ No

j. Are you under a final order of civil penalty of violating section 274C of the Immigration Act for use of fraudulent documents, or have you by fraud or willful misrepresentation of a material fact, ever sought to procure, or procured, a visa, other documentation, entry into the U.S., or any other immigration benefit?

___ Yes   __ No

k. Have you ever left the U.S. to avoid being drafted into the U.S. Armed Forces?

___ Yes   __ No

l. Have you ever been a J non-immigrant exchange visitor who was subject to the 2 year foreign residence requirement and not yet complied with that requirement or obtained a waiver?

___ Yes   __ No

m. Are you now withholding custody of a U.S. Citizen child outside the U.S. from a person granted custody of the child?

___ Yes   __ No

n. Do you plan to practice polygamy in the U.S.?

___ Yes   __ No

DOCUMENTS REQUIRED

1.  A copy of your US certificate of birth or US passport or certificate of naturalization

2. Evidence of your relationship with your alien relative (marriage certificate, birth certificate etc.)

3. If filing for wife/ husband, one immigration photo from you

4. A full copy of your alien relative's passport

5. A copy of your alien relative's I-94

6. Copies of all previous I-20, IAP66, H1B, L1 approval notices etc. of your alien relative (if applicable)

7. Birth Certificate of Your Alien Relative

8. Six (6) passport photos from your alien relative (Please click here to see photo requirement)

9. Medical Examination Results (Form I-693)

10. Your three years tax return, including all schedules and W2s.

11. Your employer verification letter from your current employer

12. Your most recent paycheck stub  

13. If your alien relative is currently in valid H1, L1, E, or O1 status, a copy of employment verification letter from his/her current employer, and a copy of most recent paycheck sub.

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