Lawful Presence Verification Form

Full Name

First NameLast Name

Phone Number

Please enter a valid phone number.

Email

example@example.com

Date of Birth

Date

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Citizenship

U.S. CitizenPermanent Resident (Green Card Holder)Temporary Visa HolderOther

Document Verification (Attach copies of applicable documents)

U.S. Passport (Copy Attached)Certificate of Naturalization (Copy Attached)Certificate of Citizenship (Copy Attached)Permanent Resident Card (Copy Attached)Employment Authorization Document (EAD) (Copy Attached)Visa Document (Copy Attached)Other

Upload Documents

I, the undersigned, declare that the information provided in this Lawful Presence Verification Form is true, accurate, and complete to the best of my knowledge. I understand that providing false or misleading information may result in legal consequences.

Date

Signature

Lawful Presence Verification Form

Applicant Information

Verification Information

Declaration