U.S. CITIZEN's name: FIANCE's name: Is the U.S. CITIZEN male or female? Is the FIANCE male or female? U.S. CITIZEN's date of birth: FIANCE's date of birth: FIANCE's country of citizenship: U.S. CITIZEN's alien number (if any): FIANCE's alien number (if any): Any other names which the U.S. CITIZEN has ever used: Any other names which the FIANCE has ever used: U.S. CITIZEN's City of Birth: U.S. CITIZEN's Country of Birth: FIANCE's City of Birth: FIANCE's Country of Birth: U.S. CITIZEN's Social Security Number (if any): FIANCE's Social Security Number (if any): U.S. CITIZEN's father's first name: U.S. CITIZEN's father's last name: FIANCE's father's first name: FIANCE's father's last name: U.S. CITIZEN's mother's first name: U.S. CITIZEN's mother's maiden name (maiden name means the last name at the time she was born): FIANCE's mother's first name: FIANCE's mother's maiden name: U.S. CITIZEN's father's date of birth: U.S. CITIZEN's mother's date of birth: FIANCE's father's date of birth: FIANCE's mother's date of birth: City and country where U.S. CITIZEN's father was born: City and country where FIANCE's father was born: City and country where U.S. CITIZEN's mother was born: City and country where FIANCE's mother was born: City and country where U.S. CITIZEN's father lives now: City and country where U.S. CITIZEN's mother lives now: City and country where FIANCE's father lives now: City and country where FIANCE's mother lives now: How many times has U.S. CITIZEN been married before?
For each former spouse, list:
former spouse's first name: - former spouse's maiden name:
- former spouse's date of birth:
- date when U.S. CITIZEN married former spouse:
- place where U.S. CITIZEN married former spouse:
- date when U.S. CITIZEN divorced former spouse:
- date when former spouse died (if applicable):
- place where divorce decree was entered:
- place where former spouse died (if applicable):
How many times has FIANCE been married before?
For each former spouse, list: - former spouse's first name:
- former spouse's last name:
- former spouse's date of birth:
- date when FIANCE married former spouse:
- place where FIANCE married former spouse:
- date when FIANCE divorced former spouse:
- date when former spouse died (if applicable):
- place where divorce decree was entered:
- place where former spouse died (if applicable):
U.S. CITIZEN's current address: What month and year did U.S. CITIZEN begin living at this address: Make a list of all addresses where U.S. CITIZEN has lived for the last 5 years: What month and year did U.S. CITIZEN begin living at each address listed above? What month and year did U.S. CITIZEN stop living at each address listed above? FIANCE's current address: What month and year did FIANCE begin living at this address? Make a list of addresses where FIANCE has lived for the last 5 years: What month and year did FIANCE begin living at each address listed above? What month and year did FIANCE stop living at each address listed above? Has U.S. CITIZEN lived at any address outside of the United States for more than 1 year?
IF YES, what is the LAST address where U.S. CITIZEN lived outside the United States for more than 1 year?
What month and year did he begin living there?
What month and year did he stop living there? Has FIANCE lived at any address outside of the United States for more than 1 year?
IF YES, what is the LAST address where FIANCE lived outside the United States for more than 1 year?
What month and year did she begin living there?
What month and year did she stop living there? Please make a list of all of U.S. CITIZEN's places of employment for the past 5 years: What is the address for each place of employment? What was U.S. CITIZEN's job title at each place of employment? What month and year did U.S. CITIZEN start working at each job? What month and year did U.S. CITIZEN stop working at each job? Please make a list of all of FIANCE's places of employment for the past 5 years: What is the address for each place of employment? What was FIANCE's job title at each place of employment? What month and year did FIANCE start working at each job? What month and year did FIANCE stop working at each job? Has U.S. CITIZEN ever been employed outside of the United States?
IF YES, who was U.S. CITIZEN's LAST employer outside the United States?
What was the address of the employment?
What was U.S. CITIZEN's job title?
What month and year did U.S. CITIZEN start working there?
What month and year did U.S. CITIZEN stop working there? Has FIANCE ever been employed outside of the United States?
IF YES, who was FIANCE's LAST employer outside the United States?
What the address of the employment?
What was FIANCE's job title?
What month and year did FIANCE start working there?
What month and year did FIANCE stop working there? Has U.S. CITIZEN ever filed a petition for FIANCE or any other fiancé or husband or wife before?
If yes, please list the places, dates and results of prior petitions: Has U.S. CITIZEN ever filed a petition for any other spouse or fiance before?
If yes: please list the names, places and dates and the results of the petitions: Has FIANCE ever been in the United States before? Is FIANCE in the United States right now?
If yes: in what status did FIANCE enter?
If yes: What is FIANCE's I-94 number?
If yes: What was FIANCE's date of arrival?
If yes: What is the date FIANCE's authorized stay will expire as shown on the I-94? Has FIANCE ever had any children anywhere in the world?
If yes, number of children:
For each child, please list:
Child's Name:
Child's Date of Birth:
Child's country of birth:
Child's current country of residence: What is FIANCE's address outside the United States? What is FIANCE's telephone number? Are U.S. CITIZEN and FIANCE related to each other through any family relationship (for example, second cousins)? What is the most recent date when U.S. CITIZEN and FIANCE met and saw each other in person? Where did the most recent meeting take place? What is U.S. CITIZEN's e-mail address (if any)? What is FIANCE's e-mail address (if any)? Is U.S. CITIZEN currently serving in the U.S. Armed Forces overseas?
If yes: What is U.S. CITIZEN's current mailing address?
If yes: What date does U.S. CITIZEN plan to return to the U.S.? Has U.S. citizen ever been convicted of any of the following crimes? - domestic violence, sexual assault, child abuse, child neglect, dating violence, elder abuse or stalking?
- homicide, murder, manslaughter, rape, abusive sexual contact, sexual exploitation, incest, torture, trafficking, peonage, holding hostage, involuntary servitude, slave trade, kidnapping, abduction, unlawful criminal restraint, false imprisonment or an attempt to commit any of these crimes?
- 3 or more convictions relating to a controlled substance?
- 3 or more convictions relating to alcohol?
(NOTE: A conviction for one or more of these crimes will not prevent the case from being approved. If such a criminal conviction exists, the Embassy is required to notify the Fiance about the conviction(s) at the interview so that the Fiance can decide if he/she still wants to proceed with the case.) What is U.S. CITIZEN's daytime telephone number? Has the Petitioner ever been arrested or charged with any crime anywhere in the world? If so, what were the charges, when did they occur, and what happened with the case? Return completed questionnaire to: JOHN M. VICKERSTAFF
VICKERSTAFF LAW OFFICE, PSC
4109 Bardstown Road, Suite 106
Louisville, KY 40218
Telephone (502) 491-0197
Facsimile (502) 491-0719
john@vickerstafflaw.com
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