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Home
About Us
Immigration Services
USCIS Processing Times
Visa Bulletin
Immigration Approvals
Immigration News
Blog
中文
Contact Us
info@messersmithlaw.com
+1 305-515-0613
390 N Orange Ave, Suite 2300, Orlando, FL 32801
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Change/Extension of Status Questionnaire
Questionnaires – Main Page
Change/Extension of Status Questionnaire
Change/Extension of Status Questionnaire
For Nonimmigrant Visa Status Applications
The Messersmith Law Firm Immigration Lawyer Services
We make immigration possible
1. Information about you
Name
First
Middle
Last
Home Phone Number
Cell Phone Number
Email
Current US Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Foreign Address
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia (Republic of)
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States of America
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Viet Nam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Alien Number (USCIS Number or A#, if any)
Social Security Number (SSN, if any)
Birth Location (City, State, Country)
Country of Citizenship or Nationality
Date of Birth
Date of Last Arrival
I-94 Number
Passport Number
Passport Country of Issuance
Passport Expiration Date
Current Nonimmigrant Visa Status
Date Current Visa Status Expires
2. Additional questions about you
Are you an applicant for an immigrant visa?
No
Yes
Has an immigrant petition ever been filed for you?
No
Yes
Have you ever filed an I-485 Adjustment of Status application?
No
Yes
Have you ever been arrested or convicted of any criminal offense since last entering the United States?
No
Yes
Have you ever ordered, incited, called for, committed, assisted, helped with, or otherwise participated in acts involving torture or genocide?
No
Yes
Have you ever ordered, incited, called for, committed, assisted, helped with, or otherwise participated in killing any person?
No
Yes
Have you ever ordered, incited, called for, committed, assisted, helped with, or otherwise participated in intentionally and severely injuring any person?
No
Yes
Have you ever ordered, incited, called for, committed, assisted, helped with, or otherwise participated in engaging in any kind of sexual contact or relations with any person who did not consent or was unable to consent, or was being forced or threatened?
No
Yes
Have you ever ordered, incited, called for, committed, assisted, helped with, or otherwise participated in engaging in limiting or denying any person's ability to exercise religious beliefs?
No
Yes
Have you ever served in, been a member of, assisted, or participated in any military unit, paramilitary unit, police unit, self-defense unit, vigilante unit, rebel group, guerrilla group, militia, insurgent organization, or any other armed group?
No
Yes
Have you ever worked, volunteered, or otherwise served in any prison, jail, prison camp, detention facility, labor camp, or any other situation that involved detaining persons?
No
Yes
Have you ever been a member of, assisted, or participated in any group, unit, or organization of any kind in which you or other persons used any type of weapon against any person or threatened to do so?
No
Yes
Have you ever assisted or participated in selling, providing, or transporting weapons to any person who, to your knowledge, used them against another person?
No
Yes
Have you ever received any type of military, paramilitary, or weapons training?
No
Yes
Have you done anything that violated the terms of the nonimmigrant status you now hold?
No
Yes
Are you now in removal proceedings?
No
Yes
Have you been employed in the United States since last admitted or granted an extension or change of status?
No
Yes
Are you currently or have you ever been a J-1 exchange visitor or a J-2 dependent of a J-1 exchange visitor?
No
Yes
3. Enter the information of the person submitting this questionnaire.
Name
*
Email
*
Phone
Submit