I. Application Fees
An unmarried person may file one application per year. If married, each spouse may file an application. Therefore, our service fees are $99 for an unmarried person (1 application) and $149 for a married couple (2 applications). You may pay our service fees by credit or debit card after completing this online questionnaire. If you do not have a credit or debit card, you may pay by check or money order through our offline application here. We also offer discounted rates for multiple entries over several years.
If the digital photos you supply do not meet submission requirements, we will reformat your photos. If the photos provided cannot be formatted to meet the submission requirements, we will notify you so you can provide alternative photos. If you do not have digital photos, you can mail your photos to our offices separately or use the offline application form.
II. Applicant Information
Family Name*
First Name*
Middle Name*
Address (Street Name and Number)*
Apt Number
City*
State/Province*
Country*
Zip Code*
City of Birth*
Country of Birth*
Education*
Work Experience (years)
Date of Birth (mm/dd/yyyy)*
Sex*
Marital Status*
Photograph (requirements)
Male Female
Single Married Divorced Widowed Legally Separated
Father’s Country of Birth
Mother’s Country of Birth
III. Applicant Spouse Information (if any)
Family Name
First Name
Middle Name
City of Birth
Country of Birth
Sex
Date of Birth (mm/dd/yyyy)
IV. Applicant Child Information (if any) - 1st
V. Applicant Child Information (if any) - 2nd
VI. Applicant Child Information (if any) - 3rd
VII. Applicant Child Information (if any) - 4th
VIII. Applicant Child Information (if any) - 5th
IX. Enter the information of the person submitting this questionnaire.
Name*
E-mail Address*
The Messersmith Law Firm, P.C.230 E Ohio Street · Suite 208 · Chicago, IL 60611Tel: (312) 751-9960 · Fax: (312) 751-9970 · info@messersmithlaw.com© Copyright 2002-08 - The Messersmith Law Firm, P.C. All Rights Reserved.
