No |
Yes |
(i) Any temporary or permanent civil protection order or restraining order issued against the United States
client.
|
No |
Yes |
(ii) Any Federal, State, or local arrest or conviction of the United States client for homicide, murder, manslaughter,
assault, battery, domestic violence, rape, sexual assault, abusive sexual contact, sexual exploitation,
incest, child abuse or neglect, torture, trafficking, peonage, holding hostage, involuntary servitude,
slave trade, kidnapping, abduction, unlawful criminal restraint, false imprisonment, or stalking. |
No |
Yes |
(iii) Any Federal, State, or local arrest or conviction of the United States client for--
(I) solely, principally, or incidentally engaging in prostitution;
(II) a direct or indirect attempt to procure prostitutes or persons for the purpose of prostitution; or
(III) receiving, in whole or in part, of the proceeds of prostitution. |
No |
Yes |
(iv) Any Federal, State, or local arrest or conviction of the United States client for offenses related to controlled
substances or alcohol. |
No |
Yes |
(v) Marital history of the United States client, including whether the client is currently married, whether the
client has previously been married and how many times, how previous marriages of the client were terminated
and the date of termination. ( Month / Day / Year).
|
No |
Yes |
Has the client has previously sponsored an alien to whom the client was
engaged or married. If so, list details.
|
No |
Yes |
(vi) The ages of any of the United States client's children who are under the age of 18.
|
|
Yes |
(vii) REQUIRED: List all States and countries in which the United States client has resided since the client was 18 years of age. |
I CERTIFY AND ATTEST, under penalty of perjury and false statement, that my above CLIENT BACKGROUND INFORMATION IS TRUE AND COMPLETE. I also give my permission to Charming Brides to release and provide this information in any format to all interested foreign ladies available. I have provided any necessary additional truthful documentation to all questions answered 'Yes' above. I hereby WAIVE ANY PRIVACY RIGHTS FROM RELEASE OF THIS INFORMATION. I ALSO HEREBY RELEASE AND HOLD HARMLESS AND FOREVER DISCHARGE Charming Brides FROM ANY AND ALL LIABILITIES arising from my release of this information and any use of it.
