Eng & Nishimura

Helping US businesses compete globally
Helping immigrants achieve the American dream

I-485 Questionnaire

Please complete this questionnaire and either print it and mail it to our office or email to us by pressing the submit button at the end of the questionnaire. You will also need to provide the following documents:

  • Copy of current I-94
  • Copy of Passport (Biographical page, visa pages, pages with stamps)
  • Birth Certificate(s)
  • Marriage Certificate
  • Medical Exam from a CIS approved doctor (Call 1 (800) 375-5283 and then choose option #2)
  • Tax returns with W-2

Your Case Number
What is your case number with our office:
Your Biographical Information
First Name: Middle Name: Last Name:
Other Names Used:
Your Name As You Want It To Appear On USCIS Forms:
Sex: Social Security Number:
Birth Date:  ,  City/State of Birth: Country of Birth:
Immigration History
Date of Last Entry To US: , Place of Last Entry to the US:
Current/Last Immigration Status/Visa: Status Expires/Expired: ,
Place Visa Was Issued: Date Visa Was Issued: ,
Your Father
First Name: Middle Name: Last Name:
Birth Place:
Birth Date:  ,  City/State of Birth: Country of Birth:
Resides in City: State: Country:
Your Mother
First Name: Middle Name: Last Name:
Birth Place:
Birth Date:  ,  City/State of Birth: Country of Birth:
Resides in City: State: Country:
Your Spouses
First Name: Middle Name: Last (Maiden) Name:
Birth Date:  ,  City/State of Birth: Country of Birth:
Place of Marriage: Date of Marriage:  , 
Place Marriage Ended: Date Marriage Ended:  , 
First Name: Middle Name: Last (Maiden) Name:
Birth Date:  ,  City/State of Birth: Country of Birth:
Place of Marriage: Date of Marriage:  , 
Place Marriage Ended: Date Marriage Ended:  , 
First Name: Middle Name: Last (Maiden) Name:
Birth Date:  ,  City/State of Birth: Country of Birth:
Place of Marriage: Date of Marriage:  , 
Place Marriage Ended: Date Marriage Ended:  , 
List the Last Address Where You and Your Current Spouse Lived Together
Street Address:
City: State: Zip/Postal Code:
Country: Date Moved In: Date Moved Out:
List All Your Addresses for the Last Five Years
Street Address:
City: State: Zip/Postal Code:
Country: Date Moved In: Date Moved Out:
Street Address:
City: State: Zip/Postal Code:
Country: Date Moved In: Date Moved Out:
Street Address:
City: State: Zip/Postal Code:
Country: Date Moved In: Date Moved Out:
Street Address:
City: State: Zip/Postal Code:
Country: Date Moved In: Date Moved Out:
Street Address:
City: State: Zip/Postal Code:
Country: Date Moved In: Date Moved Out:
Street Address:
City: State: Zip/Postal Code:
Country: Date Moved In: Date Moved Out:
Street Address:
City: State: Zip/Postal Code:
Country: Date Moved In: Date Moved Out:
Street Address:
City: State: Zip/Postal Code:
Country: Date Moved In: Date Moved Out:
Current or Last Address Outside the US
Street Address:
City: State: Zip/Postal Code:
Country: Date Moved In: Date Moved Out:
Your Children
List all children, regardless of age, residence, or immigration intent.
First Name: Middle Name: Last (Maiden) Name:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
First Name: Middle Name: Last (Maiden) Name:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
First Name: Middle Name: Last (Maiden) Name:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
First Name: Middle Name: Last (Maiden) Name:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
First Name: Middle Name: Last (Maiden) Name:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
First Name: Middle Name: Last (Maiden) Name:
Sex:
Birth Date:  ,  City/State of Birth: Country of Birth:
Citizen Of: Immigration Status: Status Expires:  , 
Current Employer
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Date Hired:  
What does company do?
Prior Employers
List all employment for last 5 years
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Date Hired:   Date Left:  
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Date Hired:   Date Left:  
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Date Hired:   Date Left:  
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Date Hired:   Date Left:  
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Date Hired:   Date Left:  
Last Employer Abroad
Employer:
Street Address:
City: State: Zip/Postal Code:
Country:
Job Title: Date Hired:  
Other Information
If you have ever been arrested, please state when, for what, and the results:
If you have ever claimed to be a United States Citizen, or voted in the US, please state when, for where, and why:
If you have ever denied a visa or entry to the United States, please state when, for where, and why:
If you have been in a deportation hearing or been told to leave the US, please state when, for where, and why:
Is there any other information you think might have an impact on your immigration case:
(required)
 
Eng & Nishimura
1055 W 7th St Ste 1780, Los Angeles, CA 90017
213.622.2255
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