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Immigration Consequences Analysis Questionnaire
Email address *
Attorney First Name *
Your answer
Attorney Last Name *
Your answer
Attorney Phone Number *
(123) 456-7890
Your answer
Attorney County *
Your answer
County Where Client is Charged *
Your answer
Case Number (optional)
Your answer
Client's Full Name (optional)
Your answer
Client's Current Immigration Status *
Please check only one
What are the client's goals for this case? *
Avoid deportation, get out of jail ASAP, maintain eligibility for future immigration benefits, etc.
Your answer
Country of Origin *
Your answer
If the client is an LPR, when did he/she become LPR? *
Your answer
If the client is an LPR, when was the last time that he/she left and re-entered the US? *
Your answer
Client's current age? *
Your answer
Client's age at time of offense *
Your answer
Does the client have any family members who are Lawful Permanent Residents (LPRs) or US Citizens (USCs)? *
Answer yes or no. If yes, who and is the family member a LPR or USC?
Your answer
Does the client have a son/daughter who is a US Citizen or Lawful Permanent Resident? *
If yes, has the client lived continuously in the US since January 1, 2010?
Your answer
Date client first entered US? *
Your answer
Client's age upon entering the US for the first time? *
Your answer
Client's status when he/she entered the US? *
Other dates of entry if the client has entered the US multiple times? *
Your answer
Has the client ever had contact with ICE or Customs and Border Patrol (CBP)? *
If yes, when? What was the nature of the contact?
Your answer
Has the client been referred to Immigration Court? *
Current ICE Hold *
Has the client ever been the victim of crime? *
If yes, when, and did he/she report the crime and provide help to law enforcement?
Your answer
Is the client afraid of returning to his/her home country for any reason? *
If yes, why?
Your answer
Has the client ever applied for an immigration benefit before? *
If yes, what benefit, and what were the results of the application?
Your answer
If the client is under 21 years old and unmarried, has he/she ever been the victim of abuse, neglect or abandonment here in the US or in his/her native country? *
If yes, is the client currently under juvenile court jurisdiction? AND is reunification with one or both of the client's parents not viable because of the abuse/neglect?
Your answer
Does the client have a criminal record in any state outside of Wisconsin? *
List all criminal criminal convictions in Wisconsin, any other state, or federal *
Include name of conviction, location of conviction, year convicted, whether a misdemeanor or felony, and disposition
Your answer
Client's Current Criminal Charges *
Include all counts, statute number(s) (including enhancers) and maximum punishment
Your answer
Proposed Offer/Resolution *
If there is a proposed offer/resolution. Also, please include the proposed recommendation.
Your answer
Are there any additional criminal charges or other relevant charging information not mentioned previously? *
Your answer
Is there anything else you think we should know which we haven't asked?
Your answer
Due Date for this Request *
We will send you our analysis within two weeks unless otherwise indicated below.
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