Canero Fadul Client Questionnaire

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Canero Fadul Reis Law

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Attorney Chosen

Michelle CaneroMirtha FadulMaria Eduarda Reis Medeiros
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Michelle Canero esq. - Client Questionnaire

Please fill out the questionnaire for the individual that is need of our Immigration Services.
Mirtha Fadul esq. - Client Questionnaire

Please fill out the questionnaire for the individual that is need of our Immigration Services.
Maria Eduarda Reis esq. - Client Questionnaire

Please fill out the questionnaire for the individual that is need of our Immigration Services.
Contact Information

Please complete for the person who needs immigration services ("Client"), there's a field for your name and email if you are filling this out for someone else.
Full Name of Client Needing Immigration Services*

First NameLast Name
Name to be parsed

First NameLast Name
Email of Client*
example@example.com
Who's filling out the form?
Name of individual Completing this form (if different than client)

First NameLast Name
Email of lndividual Completing this form
example@example.com
Whatsapp Number of Client

Country CodeArea CodePhone Number
Phone Number of Client

Area CodePhone Number
International Phone Number (if applicable)

Country CodeArea CodePhone Number
Client Address

Street Address

Street Address Line 2

CityState

Zip Code
Your Last Foreign Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry/Region
Clients Date of Birth*

MonthDayYear
Date
Client Place of Birth*
Client Primary Nationality*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Client’s Second Nationality (if applicable)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Are you married?*
Date of Marriage

MonthDayYear
Date
Location of Marriage*
Spouse’s Nationality*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How Many Children do you have? (Non USC Children under 21)*
List only your children that are under 21
Please Summarize the Past Process we did for you*
About your case

To better serve you, please select any visas you have an interest in.
Are you interested in any of these Employment, Talent or Investment Visas?

O-1 - Foreign nationals possessing excellent knowledge and abilities in the fields of art, science, business and athleticsP - Entertainers, artists and athletesL - Intra company transfereesE Visas - Treaty Investor/TraderH VisasPERM/Labor CertificationEB-2/NIWEB-5EB-1A - Extraordinary AbilityEB-1C - Multinational ManagerF, J, or M - Study or Trainee visa options
Are you interested in any of the following Family based Visas?

Sponsorship by USC SpouseSponsorship by LPR SpouseSponsorship by USC or LPR ParentSponsorship by USC SiblingSponsorship by a USC Child (over 21)Fiancé Visa
Are you interested in any of the following Humanitarian based Visas?

TPSParoleAsylumCuban Adjustment (CAA)Special Immigrant Juvenile Status (SIJS)
Please describe your immigration needs in as much detail as possible.*
Choose your Appointment Type

All consultation fees within 90 days of signing will be credited towards your initial retainer.
Select your Appointment

$250 Initial Consultation - Requires additional completion of Client Questionnaire$300 Consultation - Go directly to scheduling Consultation
Preselect 250*

$250 Initial Consultation - Requires additional completion of Client Questionnaire$300 Consultation - Go directly to scheduling Consultation
Preselect 300*

$250 Initial Consultation - Requires additional completion of Client Questionnaire$300 Consultation - Go directly to scheduling Consultation
FAMILY INFORMATION
Spouses Name*

First NameLast Name
Spouses Date of Birth*

MonthDayYear
Date
Spouses Status or Visa Type*
Explain Spouses Status or Visa Type*
Child #1 Name*

First NameLast Name
Child #1 Relationship*
Child #1 Date of Birth*

MonthDayYear
Date
Child #1 Nationality
Child #1 Status or Visa Type*
Explain Child #1’s Status or Visa Type*
Child #2 Name*

First NameLast Name
Child #2 Relationship*
Child #2 Date of Birth*

MonthDayYear
Date
Child #2 Nationality
Child #2 Status or Visa Type*
Explain Child #2’s Status or Visa Type*
Child #3 Name*

First NameLast Name
Child #3 Relationship*
Child #3 Date of Birth*

MonthDayYear
Date
Child #3 Nationality
Child #3 Status or Visa Type*
Explain Child #3’s Status or Visa Type*
Child #4 Name*

First NameLast Name
Child #4 Relationship*
Child #4 Date of Birth*

MonthDayYear
Date
Child #4 Nationality
Child #4 Status or Visa Type*
Explain Child #4’s Status or Visa Type*
Child #5 Name*

First NameLast Name
Child #5 Relationship*
Child #5 Date of Birth*

MonthDayYear
Date
Child #5 Nationality
Child #5 Status or Visa Type*
Explain Child #5’s Status or Visa Type*
List any remaining Children. Provide their name, immigration status, relationship, age & Nationality *
EDUCATION INFORMATION
Your Highest Level of Education Completed*
How Many degrees are you able to list?*
Degree #1 - Field of Study*
Degree #1 Graduation Year
Degree #1 - Name of Institution*
Degree #1 - Country of Institution*
Degree #1 - Graduation Date*

MonthDayYear
Date
Degree #2 - Field of Study*
Degree #2 Graduation Year
Degree #2 - Name of Institution*
Degree #2 - Country of Institution*
Degree #2 - Graduation Date*

MonthDayYear
Date
Degree #3 - Field of Study*
Degree #3 Graduation Year
Degree #3 - Name of Institution*
Degree #3 - Country of Institution*
Degree #3 - Graduation Date*

MonthDayYear
Date
List remaining degrees with Field of Study, Graduation Date, Institution and Country*
Your Spouse’s Highest Level of Education Completed*
How Many degrees are you able to list for your spouse?*
Spouse’s Degree #1 - Field of Study*
Spouse Degree #1 Graduation Year
Spouse’s Degree #1 - Name of Institution*
Spouse’s Degree #1 - Ctry of Institution*
Spouse’s Degree #1 - Graduation Date*

MonthDayYear
Date
Spouse’s Degree #2 - Field of Study*
Spouse Degree #2 Graduation Year
Spouse’s Degree #2 - Name of Institution*
Spouse’s Degree #2 - Ctry of Institution*
Spouse’s Degree #2 - Graduation Date*

MonthDayYear
Date
Spouse’s Degree #3 - Field of Study*
Spouse Degree #3 Graduation Year
Spouse’s Degree #3 - Name of Institution*
Spouse’s Degree #3 - Ctry of Institution*
Spouse’s Degree #3 - Graduation Date*

MonthDayYear
Date
List Spouse’s remaining degrees w/ Field of Study, Graduation Date, Institution & Ctry
WORK EXPERIENCE

Complete for Employment, Talent or Investment Visa Options
How many jobs have you had over the past 5 years?*
1) Name of Employer*
1) Position*
1) Country of Employment*
1) Did you have a work Authorization?*
1) Date you began work*

MonthDayYear
Date
1) Work end-date*

MonthDayYear
Date
1) Duration of Employment*
Months
2) Name of Employer*
2) Position*
2) Country of Employment*
2) Did you have a work Authorization?*
2)Date you began work*

MonthDayYear
Date
2) Work end-date*

MonthDayYear
Date
2)Duration of Employment*
Months
3) Name of Employer*
3)Position*
3) Country of Employment*
3) Did you have a work Authorization?*
3) Date you began work*

MonthDayYear
Date
3) Work end-date*

MonthDayYear
Date
3) Duration of Employment*
Months
Any Additional work experience, skills and or recognitions
How many jobs has your spouse had over the past 5 years?*
1) Name of Spouses Employer*
1) Spouse’s Position*
1) Spouse’s Country of Employment*
1) Did spouse have work authorization?*
1) Date spouse began work*

MonthDayYear
Date
1) Spouse’s work end-date*

MonthDayYear
Date
1) Duration of spouse’s employment*
Months
2) Name of Spouses Employer*
2) Spouse’s Position*
2) Spouse’s Country of Employment*
2) Did spouse have work authorization?*
2) Date spouse began work*

MonthDayYear
Date
2) Spouse’s work end-date*

MonthDayYear
Date
2) Duration of spouse’s employment*
Months
3) Name of Spouses Employer*
3) Spouse’s Position*
3) Spouse’s Country of Employment*
3) Did spouse have work authorization?*
3) Date spouse began work*

MonthDayYear
Date
3) Spouse’s work end-date*

MonthDayYear
Date
3) Duration of spouse’s employment*
Months
Any Additional work experience, skills and or recognitions for Spouse.
Are you currently employed by a U.S. company or do you have a job offer from a US company?*

YesNo
US Employer/Petitioner Information

Please provide the information for the U.S. company that is interested in sponsoring your visa (if applicable). A U.S. Company sponsor is required for the following visas: H-1B, O-1, L-1, TN, and EB-2/EB-3 Labor Certification Greencard.
Business Name
Current Position
Employer Email address:
Salary
Yearly salary
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is there any familial relationship or ownership between your family and the sponsoring company?*

YesNo
Please explain this relationship:*
STATUS & IMMIGRATION HISTORY OF APPLICANT:
Client Alien Number: (if Applicable)
Client SSN: (if Applicable)
Current Status or Visa Type*
Explain Your ‘Other’ Status or Visa Type*
Consulate where visa issued
Visa expiration

MonthDayYear
Are you currently in the United States or are you abroad?*

I am currently in the United StatesI am currently abroad
Date of your last entry into the US

MonthDayYear
Class of Admission
I-94 Expiration

MonthDayYear
Date of Departure - old

MonthDayYear
Class of Admission old - being kept and hidden to store previously filled out data in Table
Total Time in US old
Have you or any of your family members ever accumulated over 180 days of unlawful presence?*

YesNo
Please Explain this unlawful presence:*
Have you or any family member ever filed an Immigrant petition/Adjustment of Status or ever have had a visa denied or revoked?*

YesNo
Please Explain what was filed, denied or revoked:*
Have you or any family member worked without authorization or in any way violated your status?*

YesNo
Please Explain how you may have violated your status:*
Have you ever been deported or are you currently in removal proceedings?*

YesNo
Court Date

MonthDayYear
Date
Court / Judge Information
Have you or any of your family members (Select all that apply):*

Overstayed your visaEntered the US without inspectionBeen denied entry to the US at an airport or border stationReceived an Order of RemovalBeen to Immigration CourtBeen stopped by an immigration officialHad a visa application denied at a US consulateHad an application or petition denied by USCISBeen arrested or charged with a crime anywhere in the worldBeen a victim of domestic abuse by a USC / LPR spouse, parent or childBeen a victim of a crimeWitnessed a crime in the USNone of the above
Please explain in detail your selections from above:*
If you have any documents you would like us to review during your consultation please upload below (ie. Request for Evidence from USCIS, Agency Denial, Notice to Appear in Court, Forms provided by CBP, or Consular Decision)

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How were you referred to our firm?*

Referred by Current or Former ClientReferred by Another AttorneySocial Media (Facebook, Twitter, Instagram)WebsiteMedia (TV or Radio)Other
Please list person, attorney or social platform that referred you to our office:
Please select the show:

En conexion - Cesar Miguel RondonA primera hora - Juan Camilo
In case of signing the contract, Would you like us to mail you a contract in addition to email?
Form

Initial Questionnaire
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***The use of this form does not constitute*** ***representation by Canero Fadul Immigration***
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Canero Fadul Reis Law

Michelle Canero esq. - Client Questionnaire

Mirtha Fadul esq. - Client Questionnaire

Maria Eduarda Reis esq. - Client Questionnaire

Contact Information

About your case

Choose your Appointment Type

FAMILY INFORMATION

EDUCATION INFORMATION

WORK EXPERIENCE

US Employer/Petitioner Information

STATUS & IMMIGRATION HISTORY OF APPLICANT:

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***The use of this form does not constitute*** ***representation by Canero Fadul Immigration***

The use of this form does not constitute representation by Canero Fadul Immigration