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Immigration Consequences of Criminal Convictions Intake
Full Name of Client *
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Date of Birth *
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Country of Birth *
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Alien Number (e.g. A012 345 678)
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Citizenship *
How many times have you entered the United States? *
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Did you have a visa to enter for any of these entries? *
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Date of most recent entry *
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Current immigration status? *
I have the following: *
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Have you ever been stopped by Immigration/ICE? *
Have you ever been deported? *
Do you have any papers pending with Immigration? *
If you answered 'Yes', what papers?
Your answer
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