CONTACT US

Richard I. Fleischer & Associates
917 Main Street - Cincinnati, Ohio 45202-1314 USA
Phone: 513.977.4209 - Fax: 513.977.4238

fleischer@immigrate2usa.com




PROSPECTIVE CLIENT QUESTIONAIRE

Name (required):


Email Address: (Required)


Other names previously used:


Alien Registration Number (if any):


Address: (Include City, State, and Zip Code)


Telephone Number:


Fax Number:


Date of Birth:


Place of Birth:


Current U.S. visa (if any) / Current Status:


Date of expiration:


Name of spouse:


Date of Birth:


Place of Birth:


Name[s] of Children:


Date of Birth:


Place of Birth:


Your Occupation:


Name of Employer:


Employer's Address:



Employer and length of time of each employment for last five (5) years:






Highest level of education achieved
(you may attach a Curriculum Vitae or Resume if faxing or mailing this form):


Please tell us what you would like to achieve:




Disclaimer
Nothing at this site should be construed as legal advise for any individual case or situation. This information is general content only, and should not be relied upon for any specific information. For specific legal advise consult an experienced immigration attorney.



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