Informational Questionnaire
Thank you for choosing to contact The Law Office of Philip M. Levin. If you wish to make an appointment to come in and see us, please call the office or email us at info@pmlevinimmigration.com. Once you have made your appointment, please take the time to fill out the form below. When you are done, hit "submit". This will assist us in responding to your needs expeditiously. Please note that we attempt to keep any and all information we receive electronically in the strictest confidence. The submittal of information in this questionnaire to The Law Office of Philip M. Levin in no way creates an attorney-client relationship or guarantees that The Law Office of Philip M. Levin will accept your case.
Personal Information
Full Name
E-Mail Address
Mailing Address
Business Phone Number 
Fax Number
Home Phone Number 
Date of Birth (DD/MM/YY) 
Age
Sex
Female   Male
Marital Status
Single   Married
Citizen of
Resident of
Number of Children 
Number of Married Children 
Ages of Children (seperate by commas) 
Immigration Status of Spouse

 If other, please explain
 Immigration Status of Children 
 If other, please explain
 
What type of case are you interested in?
Family
Employment
Both
Please describe your situation 
 
IF YOUR CASE IS EMPLOYMENT BASE,
PLEASE PROVIDE THE FOLLOWING INFORMATION
Your Educational Background
 Have you completed secondary school? 
 Yes   No
Have you attended a university? 
 Yes   No
Certificate/degree obtained
University Attended
Length of Program 
 Do you have an educational evaluation? 
 Yes   No
 
Employment and/or Business Experience
Job Title Offered 
Position Offered
Nature of employer's business 
What are the proposed specific 
duties and responsibilities 
Please list any other 
relevant information 
(If you have extensive 
employment experience, 
please provide a detailed resume) 
 

IF YOUR CASE IS FAMILY BASED,
PLEASE LIST ALL OF YOUR AND YOUR SPOUSE'S
U.S. CITIZEN / LAWFUL PERMANENT RESIDENT RELATIVES

FAMILY INFORMATION
Are you currently in the U.S.? 
 Yes   No
If in the U.S., what is
your current immigration status?
Have you ever been 
petitioned by a relative? 
 Yes   No
If you are a lawful permanent 
resident or U.S. citizen, 
have you ever petitioned a relative? 
 Yes   No