Vân Sơn International - Immigration Client Intake Questionnaire (English)

Instructions & confidentiality

CONFIDENTIAL CLIENT INFORMATION Please complete this form as fully and accurately as possible. If you do not know an exact answer, provide your best estimate and identify it as approximate. A “Yes” answer does not automatically prevent immigration relief or benefits. Vân Sơn International is not a law firm and does not provide legal advice or legal representation. Only a licensed attorney or a Department of Justice-accredited representative working through a recognized organization may provide immigration legal advice. Contact: (918) 204-4500 | VanSonDichVu@gmail.com | VanSonDichVu.com | DichVuPhapLyUS.com

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1. Client Information

Identity, contact information, passport details, and emergency contact.

* Required. Answers stay on this page until you send them. Closing or refreshing the page will discard unsent answers.

Personal Information

Full legal name exactly as shown on your passport or birth certificate *

Last name / family name *

First name / given name *

Middle name, if any

Date of birth *

Is the date of birth exact? *

ExactApproximateUnknown

City of birth

Province or state of birth

Country of birth *

Country or countries of citizenship *

Gender designation

MaleFemaleAnother designationPrefer not to answerOther

Current marital status *

SingleMarriedDivorcedWidowedLegally separatedAnnulled

Have you ever used another name? *

NoYes

List every other name used, including maiden names, previous married names, aliases, nicknames used on legal documents, and different spellings. Include where and when each name was used.

Identification Numbers

A-Number, if any

USCIS Online Account Number, if any

Social Security Number, if any

Enter only if needed for your matter.

Other government identification type and number

Passport

Current passport number

Country that issued the passport

Passport issue date

Passport expiration date

Current Contact Information

Current street address *

Apartment or unit number

City *

State or province *

ZIP or postal code *

Country *

Primary telephone number *

Secondary telephone number

Email address *

Preferred language for communication *

Do you need an interpreter? *

YesNo

Interpreter language, if applicable

Emergency Contact

Emergency contact full name

Relationship

Telephone number

Email address

Company

Only VânSơn’s authorized owner account can view saved submissions. Email alerts do not contain your questionnaire answers or files.