Intake Form | Law Offices of Grant Kaplan

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

In order for us to respond appropriately to your specific requirements, it would be helpful to have some background information on you. This information will be kept confidential.

Please complete the following questionnaire and e-mail or fax same back to us as soon as possible. Upon receipt of the information and after our company's attorneys have had an opportunity to study your response, you will be informed if you may qualify for a USA visa:

Name

Address

City and State

Country

Zip / Post Code

Phone (Home)

Phone (Office)

Fax

Email Address *

Are you currently residing in the U.S.?

No, I'm living abroad
Yes, I am in the U.S.

What is your country of citizenship?

Do you currently have family members living in the USA? If so, state relationship and immigration status in the USA

Do you have a University of college degree? If yes, please outline your degree certificate in purchasing & supplies/account intermediary

What is your current employment? Please describe work, and nature of business, and how long you have been employed

Do you or your family own a business? (Yes/No)

If you answered "yes" to the above question, please state the nature of business:

Years in operation:

Ownership (names/percentage):

Number of employees:

Gross sales annually:

In order for our attorneys to determine if you can obtain a visa, it is important for us to know your total net worth in US dollars (optional)

How much of this amount is in liquid assets? Please do not include real estate and personal property

How did you hear about us?

formDisclaimer The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

I have read the disclaimer *