Risk Assessment Undoc - www.blackwell-immigration.com

 

Blackwell Law Group S.C.

Immigration:

Keeping Families Together

Proudly serving families in Milwaukee, Racine, Kenosha, Waukesha, Appleton, Oshkosh, Green Bay, Manitowoc and nearby towns since 2006.

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SM

131 W. Layton Ave, Ste 201

Milwaukee, WI 53207

I AM AN UNDOCUMENTED IMMIGRANT.  AM I SAFE?

 

Name______________________________________________ ______________________M      F    Date of Birth___/___/____

 

1. When did you last enter the U.S.?      ____________  

 

2. How did you enter the U.S.?      _____Illegally (Go to Q.3)      _____ On a visa (Go to Q.4)

 

3. Illegal entries

                    3a.    How many times have you illegally entered the U.S.?      ____ Once     ____ More than once

                    3b.   If you have entered illegally more than once, list the last two dates you illegally entered and

                            last date you left the U.S.  

 

                             Last entry date          _________

 

                             Previous entry date    _________        Last departure date    ____________

 

                     3c.  Have you ever been caught at the border?     ____  No   ____ Once    ____ More than once

     

                            Dates when caught at the border___________________________

 

4. Have you ever been referred to immigration court?    ____No (Go to Q.6)    ____   Yes (Go to Q.5)

 

5. Immigration court proceedings

 

                 5a.   I am still in court proceedings           ___  No        ____  Yes (Next court date___________)

                 5b.   My case was closed                             ___  No       ____  Yes

                 5c.   I was given voluntary departure        ___  No       ____ Yes  (Estimated Date __________)

                 5d.   I was ordered removed                      ___  No       ____ Yes (Estimated Date ___________)

                 5e.   I missed my court date                       ___  No       ____  Yes

 

6. Have you ever been arrested for any crimes?____ No (Go to Q.8)   ____ Yes (Go to Q.7)

 

7. Details about the criminal arrests (exclude all traffic offenses except DUI/OWI)

 

Crime                                                                 Date          State       What happened? e.g. not prosecuted, case dismissed,    

                                                                                                                                                  fined, length of sentence and time served, probation

 

__________________________________________   __________   ______   __________________________________________________

 

__________________________________________   __________   ______   __________________________________________________

 

__________________________________________   __________   ______   __________________________________________________

 

__________________________________________   __________   ______   __________________________________________________

 

__________________________________________   __________   ______   __________________________________________________

 

8. Have you ever violated a restraining order against you?       _____ No   _____ Yes

 

FAMILY RELATIONSHIPS THAT MIGHT PROVIDE SOLUTIONS

 

9. Are you married?____  No____ Yes (Date of marriage________________)

 

                   If married, is your spouse a US citizen or lawful permanent resident?                ____  No    ____ Yes

                  If not married, do you have US citizen or lawful permanent resident partner?   ____ No    ____ Yes

 

10. Are either of your parents US citizens or lawful residents?          ____ No          _____ Yes

 

11. Children (this includes adult children too)

 

           11a    How many children do you have?   ______  (if None, go to Q. 12)

           11b    How many children are U.S. citizens or lawful permanent residents?             _______

           11c    How many U.S. citizen children are over age 21 years?                                       ______

           11d   How many lawful permanent resident children over 21 years

                     have been lawful permanent residents for at least 5 years?                               ______

 

12. Step-children (this includes adult step-children too)

 

            12a      How many step-children do you have?   ______ (if None, go to Q. 13)

            12b      How many step-children were under age 18 when you married their parent?     _____

                        12c    How many of those step-children are now lawful permanent residents

                                  for at least 5 years and over age 21?                                                                   _____

                        12d   How many of those step-children are now US citizens over age 21?             _____

 

13. Did anyone sponsor you or your spouse or your parents for a green card before 4/30/2001?    

 

      ____ No     _____ Yes

 

OTHER POSSIBLE SOLUTIONS

 

14. Have you ever been a victim of a crime?             _____ No      _____  Yes

 

         If Yes, then what crime?____________________________Date  ________State _____ City __________________

 

15. Have you ever been a victim of domestic violence?       ____  No      _____ Yes (Go to Q 15a-b)

 

           15a.  Who abused you?   _____ Spouse   ______ Parent_____ Adult child

           15b.  Was the person who abused you a US citizen or lawful permanent resident?     ____  No  _____ Yes

 

CONTACT DETAILS

 

Address__________________________________ City_______________ State_____ ZIP__________

 

Phone Number ______________________  e-mail__________________________________________

 

I understand that an attorney at Blackwell Law Group will assess my situation based on the information I have given.  I acknowledge that I am responsible for any errors or omissions that might influence the attorney's assessment.  I understand I am responsible for any negative consequences that might arise from a flawed assessment based on my errors or omissions, especially if I do not hire any immigration attorney to help me with my immigration difficulties.  An attorney at Blackwell Law Group may contact me to clarify ambiguities. I understand this assessment does not form a relationship between me and the attorney who assesses my situation.  

 

Signature_____________________________________________Date______________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This page provides a form that can be printed, completed and sent to Blackwell Law Group for a free assessment of your immigration situation so you can better understand the risks you face after January 20, 2017 and know what options you have.  Print this page, complete it and send to Blackwell Law Group via e-mail, fax or regular mail.

 

           e-mail: sarah.blackwell@blackwell-lawgroup.com                 fax: (414) 964-1902

          regular mail: 131 W. Layton Avenue, Suite 201, Milwaukee, Wisconsin 53207

 

You will receive your assessment by mail or e-mail.  The assessment will include an estimate of legal expenses if there is a solution to your immigration situation.  You are not obliged to retain Blackwell Law Group.  The estimate is to give you some idea what legal expenses you might face.  Other attorneys may give higher or lower estimates.