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Any information you send us is private and will not be shared with anyone else.

To help us assist you faster, please let us know what state you currently reside in, or if you’re abroad, and intending to relocate to the U.S., let us know what state you intend to reside in. Providing more information helps us assist you faster.

Inquiry on behalf of:
Inquirer's name:
Non-citizen's First Name:
Non-citizen's Last Name:
Address:
City:
State:
Zip:
Country of origin of non-citizen:
Current Country:
Gender:
Trans Designation:
Sexual Orientation:
HIV Status:
Is the non-citizen currently detained?
Is the non-citizen part of a binational couple?
Are there children in your family?
Please check if your household’s combined annual income is below $31,000.