Messersmith Law Firm

EB-5 Questionnaire

Please complete the following questionnaire if you are applying for permanent residency through the EB-5 program.

  1. Information about you

Family Name

First Name

Middle Name

Address (Street Number and Name)

Suite/Apt Number

City

State

Country

Zip Code

Date of Birth

Country of Birth

SSN

Alien Registration Number (A#)

Phone Number

E-mail Address

Foreign Address (Street Number and Name)

Suite/Apt Number

City

State

Country

Zip Code

Are you in deportation/removal proceedings?

Have you ever worked in the US without authorization?

  1. If you are currently in the US, please complete the following.

Date of Arrival (mm/dd/yyyy)

I-94 Number

Current Nonimmigrant Status

Date Status Expires (mm/dd/yyyy)

  1. Information about your investment

Company or Organization Name

Phone Number

Address (Street Number and Name)

Suite/Apt Number

City

State

Zip Code

EIN

Type of Business

Business Organization

Date Established (mm/dd/yyyy)

Date of Initial Investment (mm/dd/yyyy)

Amount of Initial Investment

Enterprise income when you made your initial investment

Enterprise net worth when you made you initial investment

  1. Employment creation information

Number of full-time employees when you made your initial investment

How many new jobs will be created?

Your job title with the company.

Your salary

Cost of your benefits

Your job duties

  1. Enter the information of the person submitting this questionnaire.

Name

E-mail Address

Please review all the information provided to make sure it is accurate.  You can update us later, prior to filing your application, with updated information but providing inaccurate information can lead to your application be delayed or denied. After you submit this information you will be taken to a confirmation page where we will provide you with a list of documents for your case type. We will contact you through your preferred contact method following your submission to begin working on your case.

The Messersmith Law Firm, P.C.
230 E Ohio Street · Suite 208 · Chicago, IL 60611
Tel: (312) 751-9960 · Fax: (312) 751-9970 · info@messersmithlaw.com
© Copyright 2002-08 - The Messersmith Law Firm, P.C. All Rights Reserved.