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VAWA Form

Q1. What is your Full Name?

Q2. What is your Email?

Q3. What is your phone number?

Q5. What is your relationship to a U.S. citizen or lawful permanent resident?

I am (or was) married to a U.S. citizen or lawful permanent resident

I am the child (under 21) of a U.S. citizen or lawful permanent resident

I am the parent of a U.S. citizen who is at least 21 years old

None of the above

Q6. Which best described your current marital situation?

My marriage is currently ongoing

I am divorced within the past 2 years due to abuse

I have previously filed for a green card through my spouse

None of the above apply to me

Q7. Did you ever live with your U.S. citizen or green card holder relative?

Yes, I have lived in the same home with my U.S. citizen/green card holder relative (spouse, parent or child)

No, I never lived with them

Q8. Is there any record or witness of this mistreatment?

Yes (police reports, medical records, witness statements, counseling records, etc)

No, there is no such documentation

Q9. Do you have access to documents proving your relationship (marriage certificate, birth certificate, photos together, join accounts, etc.)?

Yes

No

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