1200 NW Naito Pkwy, Suite 200 Portland OR 97209

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503-241-1320

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Client Questionnaire

Reach Our Experienced Team Today

Parker Butte & Lane PC in Portland, OR, can be reached at 503-241-1320.

Not all questions will apply to all cases. Please do the best you can in answering and leave blank anything that does not apply or that you do not understand; however, the more questions you are able to answer the more helpful your responses will be to the Attorney who evaluates your case.

ALL ANSWERS PROVIDED ARE STRICTLY CONFIDENTIAL.

Contact Us

Consultation Date

Please enter as MM/DD/YYYY

Assigned Attorney

Your Name

Please include your full name

Date of Birth

Please enter as MM/DD/YYYY

Country of Citizenship

Other Names Used

including maiden name

Gender

Place of Birth

Town/Village, State/Province & Country

US Social Security Number

If any

Alien Registration Number

If any

Email Address

Phone Number

Present US Address

Mailing Address

If different

Are you a US Citizen?

Are you a Permanent Resident?

Did you enter the US with a visa?

If so, what kind?

What is your current status?

When does/did your status expire?

Current Marital Status

New Field:

Date/Place of Marriage

Please enter as MM/DD/YYYY

Is your spouse a US Citizen?

Is your spouse a Permanent Resident?

Is your spouse a Non-Immigrant?

No Status or Status Expired?

Are either of your parents US Citizens?

Permanent Resident?

Are any of your siblings US Citizens?

Are your grandparents US Citizens?

Names, place of Birth and Birth Dates of your children:

Please enter as MM/DD/YYYY

How many times have you been married anywhere in the world?

List the full names of your current and past (if any) spouses

If you are a U.S. Citizen or Legal Permanent Resident, have you ever filed an Immigration Petition (immigrant or non-immigrant) for anyone else before? If so, what kind, when was it filed and what was the result:

If you are not a U.S. Citizen or Legal Permanent Resident, has anyone ever filed any kind of immigration application or labor certification for you - either directly or for your spouse or parent? If so, what kind, when and what was the result:

Are you coming to see us about (check which one most closely applies):

a family based case

an asylum case

a deportation case

or an employment based case

PLEASE BRIEFLY DESCRIBE YOUR CASE (i.e. What do you need help with)?

If you are the foreign national and are currently in the United States, please provide the following information:

Date and Place of last arrival in US

Please enter as MM/DD/YYYY

Name *exactly* as it appears on your I-94

Current immigration status

Date authorized status expires

Please enter as MM/DD/YYYY

Nonimmigrant Visa Number (if applicable)

Consulate where visa was issued (if applicable)

If you are not U.S. Citizen or Legal Permanent Resident and have previously been to the United States, please list dates of all entries, visa status and date of departure:

Please enter as MM/DD/YYYY

Have you ever been in removal, deportation or exclusion proceedings or been refused entry to the United State? If yes, when, what happened and what was the result?

Have you ever worked in the U.S. without permission?

If yes, please explain here:

Text Field (crime)

Text Field (arrested)

Textarea Field (arrested-description)

If you are the foreign national or a permanent resident applying for U.S. citizenship or any other benefit have you EVER:

Committed a crime for which you were not arrested?

Been the recipient of a pardon, diversion or similar action?

Engaged in prostitution in past 10 years, or likely to in future?

Engaged in unlawful commercialized vice such as illegal gambling?

Helped any alien to enter the U.S. illegally?

Trafficked in any controlled substance (drugs)?

Been in any way involved in any terrorist activity?

Exported of U.S. goods, technology, or sensitive information?

Been a member of or affiliated with the Communist Party?

Persecuted any person because of race, religion, national origin or political opinion?

Been deported or excluded from the U.S.?

Committed fraud or lied in order to obtain entry into the U.S.?

Been a nonimmigrant visitor and not complied with the 2-year foreign residence requirement or obtained a waiver?

Participated in torture, genocide, murder, assault (including sexual), or limiting or denying another’s ability to exercise religious beliefs?

Participated in any military unit, paramilitary unit, police unit, self-defense unit, vigilante unit, rebel group, militia or insurgent organization?

Served in any prison, jail, prison camp, detention facility, labor camp, or any other situation that involved detaining others?

Participated in a group that used or threatened to use any weapons against others?

Participated in selling, transporting or providing weapons to anyone who, to your knowledge, used the weapons against another person?

Received any type of military, paramilitary or weapons training?

Free Text

Questions for Employers and Employment Based Foreign National Applicants

Questions for Employers and Employment Based Foreign National Applicants

If you are the Foreign National, you must also complete the following because the answers impact your eligibility for an employment based visa and how we will proceed in your case.

Name of Employer

Employer's Address

Name of Employee

Employee's current US visa status (if any)

Expiration of Employee's current visa

Is the Employee currently working for you?

Type of visa requested

If the Employee is in H-1B of L-1 status, how long has the employee held that status?

Do you want to permanently employ this worker?

Are any petitions currently pending for this worker?

If "Yes" provide petition type and file date

Please enter date as MM/DD/YYYY

Job Title

Address where employee will work if different

Summary Job Description

Minimum Education & Experience Requirements

Special Skills Required

Offered Salary

Year Employer Established

Number of Employees

Employer's Gross Annual Income

Employer's Net Annual Income if Available

Employer's Tax Identification #

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Contact Form

Contact Us

Name

Last Name

Email Address

Phone Number

Is there a specific attorney at our firm you would like to work with?

How did you hear about us?

Your Message

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Directions To Parker, Butte & Lane PC

Albers Mill

1200 NW Naito Parkway, Suite 200 Portland, Oregon 97209

Please enter the main lobby on the north side of the building. The north entrance is ADA accessible.

Our normal office hours are Monday through Friday, 8 am – 5 pm.

Please call ahead to schedule an appointment, as we are not able to accommodate walk-ins.

Parking

Free Two-Hour Visitor Parking: There are approximately 20 spaces in the North parking lot that are marked “Visitor” on the pavement. You may use those any time they are available for up to two hours.

Other Parking: If the Free Visitor Parking is full, or if your appointment will last more than two hours, you will need to use the metered street parking available along Naito Parkway.

Alternatively, if after 10:00 am, you may also pay to park in the Non-Visitor spaces anywhere in the North parking lot (note this parking is not available before 10:00 am). To use this parking service, please use the following codes:

All day = 44626

1 hour = 44627

2 hour = 44628

3 hour = 44629

The charge is $3.00 per hour. All day is $12 starting at 10 am.

You will need your license plate number and a credit or debit card when purchasing parking.

Albers Milling Company — Portland, OR — Parker Butte & Lane PC

Phone:

503-241-1320

Email: info@pbl.net

Address:

1200 NW Naito Pkwy, Suite 200 Portland OR 97209

Business Hours:

Mon - Fri: 8:00 am - 5:00 pm
Sat - Sun: Closed

Payment Options:

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