I-140 Questionnaire

Joseph Kallabat & Associates, P.C.
7031 Orchard Lake Road, Suite 302
West Bloomfield, MI 48322
Tel (248) 865-3331 - Fax (248) 865-3323
1.
Beneficiary
A. First Name
Middle Name
Last Name
B. U.S. Address
(Number, Street, City, and Town, State ZIP code)
C. Foreign Address
(Number, Street, City, and Town, State ZIP code or Province, Country)
D. Country of Birth
E. Date of Birth
F. Social Security Number
G. Date of Last Arrival
H. I-94 #
I. Current Status
J. Expires on
K. Home Telephone
L. Work Telephone
M. E-mail Address
  N. Consular processing? yes no
  If yes, please list U.S. Consulate with jurisdiction over home country address:
  If you have checked consular processing, please provide your complete foreign address:
2.
Spouse
A. First Name
Middle Name
Last Name
B. Address
(Number, Street, City, and Town, State ZIP code)
C. Country of Birth
D. Date of Birth
E. Social Security Number
F. Date of Arrival
G. I-94 #
H. Current Status
I. Expires on

3.
Children (dependents) - Child #1
A. First Name
Middle Name
Last Name
B. Address
(Number, Street, City, and Town, State ZIP code)
C. Country of Birth
D. Date of Birth
E. Social Security Number
F. Date of Arrival
G. I-94 #
H. Current Status
I. Expires on

4.
Children (dependents) - Child #2
A. First Name
Middle Name
Last Name
B. Address
(Number, Street, City, and Town, State ZIP code)
C. Country of Birth
D. Date of Birth
E. Social Security Number
F. Date of Arrival
G. I-94 #
H. Current Status
I. Expires on

 
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