USCIS Case Intake

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Form I-821D + I-765

DACA Intake

Deferred Action for Childhood Arrivals — for individuals who came to the U.S. as children.

Personal Information

Full legal name *

Other names used aliases, maiden names

Date of birth *

Country of birth *

Email *

Phone *

Current U.S. address *

Date you moved to current address

A-Number (if any) A012345678

Immigration History

Date you first entered the U.S. *

Place / port of entry

Status at entry

Have you ever had DACA before? *

Yes No

Travel outside the U.S. since June 15, 2007 dates, destinations

Eligibility Criteria

Please answer each — these determine basic eligibility.

I was under 31 years old as of June 15, 2012

I came to the U.S. before my 16th birthday

I have continuously resided in the U.S. since June 15, 2007

I was physically present in the U.S. on June 15, 2012 and at the time of filing

I had no lawful status on June 15, 2012

I am currently in school, have graduated, have a GED, or am an honorably discharged veteran

Education Details

Current school / most recent

Graduation date (if any)

Criminal History

Have you ever been arrested, charged, or convicted of any crime (including DUIs and misdemeanors)? *

Yes No

If yes, please describe

Anything Else?

This intake form is for initial review only. Submitting it does not create an attorney-client relationship. We will follow up to schedule a consultation.

Form N-400

Naturalization Intake

For lawful permanent residents (green card holders) applying for U.S. citizenship.

Personal Information

Full legal name *

Other names used

Date of birth *

Country of birth *

Country of citizenship *

Sex

Email *

Phone *

Current U.S. address *

Permanent Resident Information

A-Number *

Date you became a permanent resident *

How did you become a permanent resident?

Eligibility basis *

5-year rule (LPR for 5+ years) 3-year rule (married to U.S. citizen for 3+ years) Military service

Marital & Family

Current marital status *

Current spouse's full name

Spouse's date of birth

Spouse's citizenship status

Date of marriage

Number of prior marriages (you and/or spouse)

Children name + DOB for each, or "none"

Address & Employment (Last 5 Years)

Addresses in the last 5 years * most recent first

Employment in the last 5 years *

Travel Outside the U.S. (Last 5 Years)

Total trips *

Longest trip (days) *

Total days outside U.S. *

Trips of 6+ months dates and destinations

Background

Have you ever been arrested, cited, charged, or convicted of any crime (including traffic citations)? *

Yes No

If yes, please describe

For males born after 1959: Did you register with Selective Service between ages 18-26?

Yes No N/A

Have you served in the U.S. armed forces?

Yes No

Test Accommodations

Do you need an accommodation for the English/civics test? age 50+ exemptions, disability accommodations

Anything Else?

This intake form is for initial review only. Submitting it does not create an attorney-client relationship. We will follow up to schedule a consultation.

Form I-485

Adjustment of Status Intake

Apply for a green card while remaining in the United States.

Personal Information

Full legal name *

Other names used

Date of birth *

Country of birth *

Country of citizenship *

A-Number (if any)

Email *

Phone *

Current U.S. address *

Most Recent Entry to the U.S.

Date of last entry *

Place / port of entry

I-94 number 11-digit admission record

Status at entry

Current immigration status *

Status expiration date

Basis for Adjustment

What is your basis for adjusting status? *

Petitioner / sponsor name if applicable

Relationship to petitioner

Petitioner's status

Has an I-130 or I-140 been filed/approved for you?

Marital Status

Marital status *

Spouse's full name

Spouse's date of birth

Spouse's citizenship status

Date of marriage

Children name + DOB for each; note if applying with you

History (Last 5 Years)

Addresses *

Employment *

Background

Have you ever been arrested, charged, or convicted of any crime in any country? *

Yes No

If yes, please describe

Have you ever been denied a visa, refused entry, or removed/deported from the U.S.? *

Yes No

Have you received any public benefits (SNAP, Medicaid, SSI, TANF) in the last 3 years?

Yes No

Have you completed your medical exam (Form I-693)?

Yes No Scheduled

Anything Else?

This intake form is for initial review only. Submitting it does not create an attorney-client relationship. We will follow up to schedule a consultation.

✓

Intake received

Thank you. We've recorded your information and will be in touch within one business day to schedule a consultation.