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Please enter the details of your request. A member of our support staff will respond as soon as possible.

Nombre de la Persona Completando el formulario

Format: #########

if detained list the detention facility

if detained, list detention facility

Please describe (e.g. LPR/USC partner)

Check all that apply

(N/A if not in proceedings with the Immigration Court)

¿Se ha presentado la solicitud ante el Tribunal de Inmigración o USCIS? (marque la casilla en caso afirmativo)

Please attach NTA in attachment section below.

Include relief client would apply for if PCR is successful

Include explanation of why other convictions will not bar the relief indicated aabove assuming PCR is obtained. If conviction bars asylum or withholding of removal, include an analysis of arguments that the conviction for which you are seeking PCR will not be found to be a particularly serious crime under a fact and circumstance analysis pursuant to Matter of Frectecu and related cases in Immigration Court.

The following fields are for one Criminal Case number, please enter any subsequent Criminal Cases in the next set of Criminal Case fields.

e.g. PC 245(a)(1) assault with a deadly weapon

e.g. Three years probation, 90 days county jail + additional 30 days for probation violation (total 120 days)

Check all that apply.

(optional) If you have a second Criminal Case, please enter that information in the fields below. For a third Criminal Case, enter that information in the next set of fields for a Criminal Case.

Only fill out, if submitting a second criminal case.

Only fill out if submitting a criminal case.

e.g Three years probation, 90 days county jail+additional 30 days for probation violation(total 120 days)

(optional) If you have a third Criminal Case, please enter that information in the fields below. If you have more than 3 Criminal Cases that you want to submit, please submit those as an attachment.

Only fill out if submitting a third criminal case.

only fill out if submitting a third criminal case.

e.g. Three years probation, 90 days county jail + additional 30 days for probation violation (total 120 days)

Add file or drop files here

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