Acknowledgments *
All referrals to the IRP must go through the OPDS online referral process. If you have not completed the OPDS Immigration Referral form for this case, please do so at OPDS Online Referral Forms. By making a request for a consultation with the Oregon Justice Resource Center Immigrant Rights Project (“IRP”), the requesting public defense provider (“PDP”) acknowledges that the consultation does not create any obligations by the IRP to the client of the PDP. The IRP will not contact PDP’s clients directly, and the consultation with IRP is not meant in any way to create a direct attorney-client relationship with clients of PDP. The IRP agrees to maintain the confidentiality of all information provided by the PDP, and the IRP will not engage in representation adverse to the PDP’s client. The IRP takes the position that consultations with the IRP are implicitly authorized, as the consultation allows PDP to fulfill their ethical duties to their clients.
Please refer to the email previously sent from the IRP with a link to this form and a ticket number.
Public Defense Provider ("PDP") *
Public Defense Provider ("PDP")
CLIENT INFORMATION
Client's Name *
Client's Name
If applicable/known
Date of Birth *
Date of Birth
IMMIGRATION SITUATION & HISTORY
Client's current immigration status *
Immigration status is the legal basis on which a person is present in the United States. A Lawful Permanent Resident or LPR is a person who has received a green card or "mica" from U.S. Citizenship and Immigration Services or the former Immigration and Nationality Service granting official permission to live legally in the U.S. on a permanent basis. A visa is a document constituting an official statement of the U.S. government granting a person permission to enter and be present in the United States for a predetermined length of time. To help determine status, ask if the client has a green card, work permit, I-94, visa or order from an immigration judge. If yes, email a copy of the document(s) to irp@ojrc.info.
Has client departed the United States since the first entry? *
Did client last enter at an official port of entry (e.g. border checkpoint or airport)? *
Did client have any contact with an immigration officer at last entry?
Is client currently in deportation or removal proceedings?
If client is currently in deportation or removal proceedings, when is the next court date?
If client is currently in deportation or removal proceedings, when is the next court date?
Relief from deportation or removal includes Cancellation of Removal, 212(c) Waiver, Suspension of Deportation, DACA, TPS, etc.
Has an employer or family member ever filed visa paperwork for client (i.e. I-130 or I-140 petition)? *
If yes, was the paperwork submitted prior to 04/21/2000?
Is client married, engaged, or in a domestic partnership or long-term relationship? *
Does client have children? *
A "child" includes biological, adopted or stepchild.
Are either of client's parents (including step/adopted) in the United States? *
Is client's biological mother a U.S. citizen? *
A U.S. citizen is a person who was born in the U.S., who was granted U.S. citizenship by naturalization, or who may have obtained citizenship through their U.S. citizen parents or grandparents.
Is client's biological father a U.S. Citizen? *
Were any of client's biological grandparents born in the United States?
CURRENT CHARGES
For each pending criminal case, please provide copies of the following documents, if available: 1. Discovery 2. Plea offers 3. State and FBI rap sheet Email directly to irp@ojrc.info and reference your ticket number in the subject line.
Client is Currently *
What court?
Date Offense Committed
Date Offense Committed
EXAMPLE: Count 1: Petty Theft, ORS § ###, A-Misd. Count 2: Burglary II, ORS § ###, C-Fel
Is there a domestic or family relationship between client and alleged victim? If so, specify.
Date of Next Hearing *
Date of Next Hearing
Type of Next Hearing
PRIOR CONVICTION HISTORY
For each prior out of state, municipal, or federal conviction, complete a Prior Conviction section below. If only Oregon state prior convictions, skip to the last section Miscellaneous below.
Prior Conviction #1 (Out of State, Municipal, or Federal)
Including Restraining or No Contact Order Violations, Non-traffic Violations, Traffic Crimes, and Deferred Adjudications. If client has no prior convictions, scroll down to the final section. For each prior conviction, please email copies of the following documents: 1. Charging document 2. Plea 3. Judgment and Sentence/Final Disposition Email directly to irp@ojrc.info and reference your ticket number in the subject line.
Court
Is there a domestic or family relationship between client and alleged victim? If so, specify.
Conviction by:
A "conviction" is a verdict or finding that a person is guilty of a certain crime, or any deferred adjudication or admission of guilt sufficient to sustain a charge, with a penalty, punishment or fine imposed.
E.g. pre-plea diversion, post-plea diversion, civil compromise.
EXAMPLE: Petty Theft, PC/ORS/RCW § ###, A-Misd
A sentence is the punishment imposed by the court, even if execution of sentence is suspended.
Where did client serve time?
Did client appeal conviction?
Was client found to have violated probation, parole, or a restraining order, or to have failed to appear?
If yes, please fill out a separate Conviction section for each violation and failure to appear.
Was client advised of the immigration consequences of the plea or conviction?
Prior Conviction #2 (Out of State, Municipal, or Federal)
Including Restraining and No Contact Order Violations, Non-Traffic Violations, Traffic Crimes, and Deferred Adjudications. For each prior conviction, please email copies of the following documents: 1. Charging document 2. Plea 3. Judgment and Sentence/Final Disposition Email directly to irp@ojrc.info and reference your ticket number in the subject line.
Court
Is there a domestic or family relationship between client and alleged victim? If so, specify.
Conviction by
EXAMPLE: Petty Theft, PC/ORS/RCW ###, A-Misd
Where did client serve time?
Did client appeal the conviction?
Was client found to have violated probation, parole, or a restraining order, or to have failed to appear?
If yes, please fill out a separate Conviction section for each violation and failure to appear.
Was client advised of the immigration consequences of the plea or conviction?
MISCELLANEOUS
WE RECOMMEND PRINTING THE COMPLETED INTAKE FORM FOR YOUR RECORDS BEFORE HITTING "SUBMIT."