u visa interview guide
DESCRIPTION
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U VISA INTERVIEW GUIDEINTERVIEWER: __________Date: _____/_____/_____
BACKGROUND INFORMATION
1. Name ___________________________ Aliases ________________________________
2. Date of birth ________________________ Place of Birth___________________________
3. Address:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
4. Second Address:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
5. Tel Nos.:
Home _______________________
Work _______________________
Message _____________________
6. Are you married? Yes No
If yes, what is your spouse’s status?
U.S. citizen LPR Other _______________ *Note- This Interview Guide is a modified version of a guide
prepared by the Legal Aid Foundation of Los Angeles
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7. Do you have children? Yes No
If yes, list ALL children:
Name Birth date Birth place Is child with you? If no, where is s/he?
Immigration Status
Age
8. Do you have unmarried siblings under 18? Yes No
If yes, list ALL unmarried underage siblings :
Name Birth date Birth place Is sibling with you? If no, where is s/he?
Immigration Status
Age
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VICTIM OF CRIMINAL ACTIVITY
9. What criminal activity were you a victim of?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
10. Name of the person who engaged in the criminal activity, and his/her date of birth (if
known):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
11. What is your relationship to the person who engaged in the criminal activity?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
12. When did the criminal activity occur?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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Where did the criminal activity occur?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
13. Did you report the criminal activity? Yes No
If yes, please answer the following questions:
a) Which police station did you report to?
___________________________________________________________________________
___________________________________________________________________________
b) Name of the detective/officer
___________________________________________________________________________
c) Telephone Number for the detective/officer______________________________________
d) Police Report No.__________________
14. Was the perpetrator arrested? Yes No Don’t know
If so, for what criminal activity was the perpetrator arrested?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
If no, why not?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
15. Were charges filed in court? Yes No Don’t know
If charges were filed, name of the court
___________________________________________________________________________
Case Number _______________________________________________________________
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What charges were brought?
___________________________________________________________________________
___________________________________________________________________________
If no charges were filed, why not?
___________________________________________________________________________
___________________________________________________________________________
16. Was the perpetrator convicted? Yes No
If yes, what was the sentence?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
17. Name of the DA or City Attorney who prosecuted the case
___________________________________________________________________________
___________________________________________________________________________
Telephone Number ___________________________
18. Have you cooperated with law enforcement in the investigation or prosecution of the crime?
Yes No
If yes, describe how you cooperated and who did you cooperate with?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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If no, why not
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
If possible, would you be willing to cooperate?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Is there a potential law enforcement official, or judge that may be willing to provide a
certification?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
NOTES on criminal activity/victim:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
SUBSTANTIAL HARM SUFFERED BY CLIENT
19. Have you suffered physical injuries as a result of this crime? If yes, please describe your
injuries_____________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
20. How were you harmed emotionally as a result of this crime?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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Checklist of types of harm suffered:
** Advocates read off checklist and circle those that apply in parenthesis
social isolation (victim can't: use phone, talk to family, no friends allowed)
obsessiveness and possessiveness (jealousy, accusations of infidelity)
threatens to kill or harm (victim/property/children/animals)
economic abuse (controls all money, prevents her from getting a job, takes her money)
verbal abuse (name-calling, humiliates, constant criticism of herself/family)
threatens to deport (client, children, family)
threatens to take children away
____kicked out of house or threatens to do so
husband/abuser's family ever harmed or threatened to harm you? Describe: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____other (please describe):
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
21. Were your children harmed as a result of this crime? Yes No
If yes, please describe how they were harmed
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
22. If the applicant is under 21, was his/her unmarried sibling under 18 harmed as a result of this
crime? Not applicable Yes No
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If yes, please describe how he/she was harmed
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
23. Were there other witnesses or victims? Yes No
If yes, who are they?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Are you in contact with them? Yes No
If yes, where are they?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
If no, can you find them? Yes No
NOTES on substantial harm suffered:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
INADMISSIBILITY ISSUES
Unlawful Presence
24. When did you first enter the U.S? ________________ Place of entry ___________________
25. How did you enter the U.S? ____________________________________________________
26. Have you left the U.S. since your first entry? Yes No
If yes, give details of each entry and exit:
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Departure Date Arrival Date Manner of entry Place of entry
Criminal History 27. Have you ever been arrested? Yes No
If yes, complete the following:
Date Charge Convicted Y/N? Sentence or Outcome
Prior Removals
28. Have you ever been before an Immigration Judge? Yes No
If yes, describe why you were put in deportation proceedings
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
What relief did you apply for?
___________________________________________________________________________
___________________________________________________________________________
What was the outcome?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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29. Have you ever been stopped or detained by INS, CIS, ICE or CBP?
______________________________________________________________________________
______________________________________
When?_____________________________________________________
Outcome?__________________________________________________
30. Have you ever been ordered deported or removed from the U.S?
Yes No
If yes, were you (check one):
__ deported/removed by the USCIS
__ Voluntarily departed
__ Never left
If yes, when?________________________________________________
Miscellaneous Inadmissibility Issues
31. Do you suffer from any serious medical condition or contagious disease? Yes No
If yes, please give details about your illness and treatment
___________________________________________________________________________
___________________________________________________________________________
______________________________________________________________________
32. Have you engaged in prostitution in the U.S. or anywhere in the world? ? Yes No
If yes, please give more information
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
33. Have you received public benefits? Yes No
34. Were the benefits provided for: applicant applicant’s children
Please explain:
___________________________________________________________________________
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___________________________________________________________________________
___________________________________________________________________________
NOTES on inadmissibility issues:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Miscellaneous
35. Do you have any other family in the U.S.? Yes No
If yes, who? _______________________________________________________
What is their status?
a. U.S. citizen LPR Other _________________________
b. U.S. citizen LPR Other _________________________
36. Do you want to apply for visas for your family? Yes No
If yes, circle all that apply:
Mother
Father
Spouse
Children
Sibling(s) (Only if the applicant is under 21 and the sibling is both unmarried and under 18.)
37. What is your current immigration status?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
38. Have you filed any applications with USCIS? Yes No
If yes, describe what you applied for, when and the outcome
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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Supporting Documents
Do you have any of the following or can you obtain these documents?
Police Report(s):
Date: Agency:
Conviction Documents/ Case Disposition: Date Convicted: Court Name:
Restraining Order: Date Obtained ______________________
Certification from law enforcement:Date Name of agency
and official:
Photographs of Injuries
Medical Report: Date: Hospital:
DV Counseling Letter: Date: Agency Name or
Name of Counselor:
Letter from Battered Women’s Shelter: Date: Name of Shelter:
Declaration of Witness: Name: Relationship:
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Client Declaration
Other Documents: ________________________________________________________________________________________________________________________________________________
FOR ADVOCATE: If client has a potential U Visa case, evaluate if they should apply for interim relief:
Is the client a direct victim of a criminal activity described in INA §101(15)(U)?
Is the crime listed in the statute?
Was the crime committed in the U.S fairly recently OR
Is the investigation/prosecution of the crime ongoing?
Has client cooperated with law enforcement?
Will law enforcement sign the Certification?
Can client show “substantial” physical/mental harm?
Is there strong corroborative evidence of harm?
Does client have other avenues of immigration relief? OR
Does client have existing immigration status?
No inadmissibility issues are present
Client has been advised of the dangers in applying for interim
relief and has consented
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