CONFIDENTIAL BIOGRAPHIC INFORMATION
LAW OFFICES OF JOHN J. HYKEL
PLEASE PRINT
DATE: _________________
MALE_______________
INTERNAL USE ONLY
FEMALE_______________
How did you hear about Mr. Hykel?
Internet_______ Friend/Relative_______ Another Attorney________ Other (Please Describe) _________________________________
_______________________________
FAMILY NAME
________________________________
FIRST NAME
Married_______
Widowed_______
____________________
MIDDLE NAME
MARITAL STATUS:
Single_______
Divorced_______
ADDRESS:
____________________________________________________________________________________________
House No. and Street
____________________________________________________________________________________________
City, State, Zip Code
Home Phone: ______________________ Business Phone: _____________________ Email: ____________________________________
BIRTHDATE: _______________________________________
Month
Day
Year
BIRTHPLACE: _________________________________________
City and Country
PASSPORT ISSUED BY: ____________________________
TYPE OF VISA HELD: __________________________________
DATE ADMITTED: ________________________________AUTHORIZED STAY EXPIRES: ________________________________
INFORMATION AS TO SPOUSE (HUSBAND OR WIFE)- IF NONE, SO STATE
__________________________
Family Name
________________________
First Name
____________________________
City & Country of Birth
___________
Date of Birth
Present Address: __________________________________________________________________________________________________
(If with you, so state)
Occupation of Spouse: _____________________________________________________________________________________________
INFORMATION ABOUT YOUR EDUCATION
NAME/ADDRESS OF SCHOOLS,
FIELD OF STUDY
DATES ATTENDED
DEGREE OR CERTIFICATE
COLLEGES OR UNIVERSITIES
FROM
TO
RECEIVED
ATTENDED
MO/YR
MO/YR
Languages You Can Speak: _________________________________________________________________________________________
Describe Any Special Qualifications, Skills or Proficiency in the Use of Tools, Machines or Equipment, Professional Licenses:
_________________________________________________________________________________________________________________
Have you ever been fingerprinted? _________ Yes or _________ No; If so, when _____________________________________________
Have you, in any country, ever been arrested or charged with any crime; if so please provide the following:
Date of Arrest ______________________
Charges Against You_____________________________________
RELATIVES AND FRIENDS IN THE UNITED STATES:
Name
Relationship
Immigration Status
Present Address
Phone Number
If Alien has a Job Offer, Give Name and Address of Prospective Employer:
_________________________________________________________________________________________________________________
Work Experience:
Describe in Full All Jobs Held Whether in the United States or Abroad, Beginning with Present Job:
Name/Address of Employer
Type of Business
Title of Job
Dates Worked
From
To
Description of Work Performed: _____________________________________________________________________________________
_________________________________________________________________________________________________________________
Name/Address of Employer
Type of Business
Title of Job
Dates Worked
From
To
Description of Work Performed: _____________________________________________________________________________________
_________________________________________________________________________________________________________________
Name/Address of Employer
Type of Business
Title of Job
Dates Worked
From
To
Description of Work Performed: _____________________________________________________________________________________
_________________________________________________________________________________________________________________
For Internal Use Only
Date_____________________________________
Inquirer__________________________________
Seen By __________________________________
Consultation Fee___________________________