Military Immigration Intake Form

This form should only be completed if the Law Firm has provided the link or instructed you to do so. This provides all of the information needed to prepare a Military Parole in Place and Military Deferred Action filing, to include an eligibility affidavit, and the servicemembers request letter. Please take your time as you answer questions on this page.

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Entry Information

  • Amount of Entries:Date/s of Entry/sPlace/s of Entry/sMethod (walking, by vehicle, swimming, by plane, by boat, etc.)Was there any interaction with Immigration Officers or Border Patrol? (Yes or No) 
  • Entry Number based on above Entry InformationNumber of people with you at the time of entryNames and Relationships to PeopleAge of Person/People at time of entryNotes you would like to add 
  • This field is for validation purposes and should be left unchanged.