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Immigration Client Intake Form

This document contains a client intake form for Carlos Daniel Castro. It collects information such as his name, address, date of birth, citizenship, education history, and immigration status. Key details include that he is a citizen of Colombia, holds a valid B1-B2 visa for the US expiring in April 2024, has over 10 years of experience working for American companies as an accountant, and has no criminal convictions or medical conditions. The form is signed by Daniel Castro, declaring that the information provided is true to the best of his knowledge.

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MARIANA RIAÑO
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43 views2 pages

Immigration Client Intake Form

This document contains a client intake form for Carlos Daniel Castro. It collects information such as his name, address, date of birth, citizenship, education history, and immigration status. Key details include that he is a citizen of Colombia, holds a valid B1-B2 visa for the US expiring in April 2024, has over 10 years of experience working for American companies as an accountant, and has no criminal convictions or medical conditions. The form is signed by Daniel Castro, declaring that the information provided is true to the best of his knowledge.

Uploaded by

MARIANA RIAÑO
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Client Intake Form Details
  • Additional Client Information

10360 W.

State Road 84, Fort Lauderdale FL 33324 | Phone: (954)370-9970, Fax: (954)382-1988
[Link]

**************************************************
CLIENT INTAKE FORM
**************************************************
CLIENT INFORMATION:

Full Name: Carlos Daniel Castro

Home Address: Cra 74 # 76 - 71

Telephone: +573102440068

Fax:

Email: daniel88399@[Link]

Place of Birth: Colombia

Date of Birth: [Link].1988

Country of Citizenship: Colombia


Do you hold a passport to any country other than your birth country? (Please Check) Yes No x

 Are you eligible for another country’s citizenship? (Please Check) Yes No x
 If Yes, what country?

 Do you currently have a United States Visa? (Please Check) Yes x Expiration Date Apr.2024 No

 Do you have a form I-94? (Please Check) Yes Expiration Date No x

 Have you ever applied for a United States Visa? (Please Check) Yes x Type of Visa B1-B2 No

 Can you demonstrate that you have maintained immigration legal status with documentation such as pay stubs, tax
returns, W-2, termination, resignation letters, etc…? (Please Check) Yes X No

 Please describe any deadline that may be present on your case. (Examples: grace period, I-20 expiration, I-94 record
expiration) NA

 Please list all degrees (College or University Diploma) or any other Business background as well as your professional
resume. Accountant Public, Certified Internal Auditor, Master Degree, Recognition of academic scholarship granted by the Organization of American States
(OAS) to study Master's studies, 10 years of experience in American Companies.
 Do you have any family members who are either U.S. Citizens or Residents? (Please Check) Yes No X

Have you or your Spouse ever been denied entry to the United States? (Please Check) Yes No X
 If Yes, please briefly explain the circumstances.

Have you or your Spouse ever been convicted of a crime? (Please Check) Yes No x

 If Yes, please briefly explain the circumstances.


Do you know of any medical condition that may disqualify you, your spouse or your children under the age of 21
from receiving U.S. immigrant visas? (Please Check) Yes No x

*************************************************************************************************************

I, Daniel Castro (name of Client) do hereby declare I have completed this Intake Form to the best of my
knowledge under penalty of perjury.

Signed: ________________________________

[Link].2020
Date: _________________________________

10360 W. State Road 84, Fort Lauderdale FL 33324 | Phone: (954)370-9970, Fax: (954)382-1988 www.kelleykronenberg.com
 Do you have any family members who are either U.S. Citizens or Residents? (Please Check) Yes No Have you or you

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