Residential and Employment Form

Please complete this Residential and Employment Form to the best of your ability. Please pay close attention to the dates and zip code / postal codes. Additionally, please provide the last foreign address, even if only lived abroad while a baby.

Note: This information assists the USCIS Background Check and will be scrutinized by many Immigration Officers. Please make sure to include Month, Day, and Year, (MM/DD/YYYY). The office may request the form to be filled out again if failure to provide the entire date.

This form should only be completed if the Law Firm has provided the link or instructed you to do so.


  • Full Address (Street/City/State/Country/ZipCode)Move-in Date (MM/DD/YYYY)Move-out Date (MM/DD/YYYY) 
    Please list dates as (MM/DD/YYYY)
  • Move-in Date (MM/DD/YYYY)Move-out Date (MM/DD/YYYY) 
  • NameAddressJob TitleStart Date (MM/DD/YYYY)Stop Date (MM/DD/YYYY) 
    Please list dates as (MM/DD/YYYY)
  • Name of BusinessFull AddressJob TitleStart Date (MM/DD/YYYY)Stop Date (MM/DD/YYYY)
    Please list dates as (MM/DD/YYYY)
  • This field is for validation purposes and should be left unchanged.