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Folau Samoa
Via Alofa provides educational support and referral services.
Submission of this form does not create an attorney-client relationship.
Citizenship Intake Form
First name
*
Last name
*
Email
*
Phone
DOB or Age
Place of Birth
Country of Citizenship
What is your current immigration status?
*
US National
Lawful Permanent Resident - LPR (Green Card Holder)
No Status
Visa Overstay
DACA
Other
Lawful Permanent Resident - LPR Information
If you are a LPR, please tell us the date you became an LPR (approximate is okay):
What is your A number?
When did you enter the U.S.?
When was the last time you entered the U.S.?
How did you obtain your Green Card?
Marriage
Family Petition
Employment
Asylum/Refugee
Other
Have you ever left the United States for more than 6 months at one time?
Yes
No
If Yes, please tell us the duration longest trip outside the U.S. and when:
Marriage to a U.S. Citizen
Are you currently married to a U.S. citizen?
YES
NO
If Yes, DATE of marriage:
Is your spouse still a U.S. citizen?
YES
NO
Criminal & Immigration History
Has any paperwork been filed on your behalf or for your parent (ex: visa petition by family)?
YES
NO
Have you ever claimed to be a U.S. citizen?
YES
NO
Have you ever been in removal or deportation proceedings?
YES
NO
Have you ever worked in the U.S.?
Have you ever failed to file taxes?
YES
NO
Do you owe child support?
YES
NO
Have you ever been arrested, cited, or charged with a crime?
YES
NO
Have you ever had trouble with the police (including parking tickets) or been arrested in the United States, even if you didn’t have to go to court?
YES
NO
If yes, please tell us when and the charges/result.
Have you ever been a victim of a crime n the US? If yes, tell us the crime and whether it was reported to the police, and the result.
English and Civics
Are you comfortable reading and writing basic English?
YES
NO
Do you have basic English and Knowledge of U.S. History and Government
YES
NO
Do you support the U.S. Constitution?
YES
NO
Did you and would you take an oath of allegiance to the U.S.?
YES
NO
Timing
When would you like to apply for citizenship?
As soon as eligible
Within 6 months
Just exploring options
SUPPORTING DOCUMENTS & FEES CHECKLIST
Copy of Legal Permanent Resident Card (front and back)
Certified Copy of Conviction, Arrest, Citation/DMV Traffic Record (if applicable)
IF MARRIED, proof of U.S. Citizenship for spouse (birth certificate/passport);
IF MARRIED, Marriage Certificate;
IF MARRIED, Documents referring to you and your spouse (utility bills, phone bills, etc
IF MARRIED, Tax returns (3 years), bank accounts, leases, mortgages, child(ren) birth certificate
Proof of termination of prior marriages (if applicable);
Filing fee: $760 (paper filing); $710 (online filing)
Will you need a fee waiver or a fee reduction?
YES
NO
Is there anything else you’d like to share with us today?
ACKNOWLEDGEMENT:
By signing below, I acknowledge that Folau Samoa provides visa support and guidance services only. I understand that Folau Samoa is not a government agency, and submission of this form does not create an attorney-client relationship.
*
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SUBMIT FORM
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