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Immigrant Legal Center
An Affiliate of the Justice
For Our Neighbors Network
4223 Center Street
Omaha, NE 68105


402.898.1349 | info@immigrantlc.org

An Affiliate of the Justice For Our Neighbors Network

Pro Bono Detainee Intake Form

READ THIS PAGE VERY CAREFULLY BEFORE COMPLETING THIS INTAKE:

Pro Bono Detainee Project Representatives are NOT my Attorneys:

Pro Bono Detainee Intake Form

  • I understand that completing this intake does not guarantee that I will receive a pro bono attorney to represent me in immigration court. I understand that the Pro Bono Detainee Project is not agreeing to represent me with my immigration case. The Pro Bono Detainee Project representative reviewing my information is not my attorney and will not appear in court on my behalf. I understand that I should begin looking for a private attorney if I am able. By signing below, I acknowledge that I have read the foregoing and agree to the terms.
  • I authorize Pro Bono Detainee Project representatives to review the information I have provided on this intake and to share all relevant information and documentation to other parties for the sole purpose of attempting to obtain a legal representative for me. I also acknowledge that I have willingly given the information above and I authorize its disclosure to other parties for the sole purpose of trying to obtain a legal representative for me. However, I understand that completing this intake does not guarantee that I will receive a pro bono attorney to represent me in immigration court. By signing below, I acknowledge that I have read the foregoing and agree to the terms.
  • The Nebraska Immigration Legal Assistance Hotline (NILAH) is a collaboration of legal services providers that provide resources and immigration legal assistance. The partners in the NILAH collaboration are Catholic Charities, the Center for Legal Immigration Assistance, Centro Hispano Comunitario de Nebraska, Multicultural Coalition, Immigrant Legal Center, Lutheran Family Services of Nebraska, the Women’s Center for Advancement, Nebraska Appleseed and Legal Aid of Nebraska. The NILAH partners are working together to provide holistic legal assistance to community members. This may include issues related to immigration, employment, wages, housing, transportation and other matters. Exchange of basic information with NILAH partners is needed to provide referrals to NILAH partners and holistic legal services by the partners. The sharing of basic information will be with NILAH partners who are working with and advocating on behalf of the client. Basic information may include your name, address, telephone number, birth date and general information about your situation, legal claims and potential legal claims you may have. This confidential sharing of information is not intended to waive any attorney-client privilege or work product privilege. I, (name of client) hereby, specifically authorize any employee of (NILAH Partner) as my legal representative, to consult with, share and obtain from any employees or representatives of the NILAH partners on basic information regarding myself and any legal claims may I have in connection with my legal claims related to and in investigating those legal claims. This does not include any of my asset and income information, information regarding my family or any information that is not relevant to my legal claims. A photocopy, email or facsimile of this document shall be deemed as an original. This Authorization for Release of Information is valid for one year from the date of signature.
  • Preliminary Questions

  • Biographical Information

  • This number is a unique number issued by immigration and used to identify the individual. This number begins with the letter A and is followed by eight or nine digits.
  • Entries into the U.S.

  • If entered without inspection or without permission, check 'EWI'
  • Border

  • Qualifying Relatives

  • Past Immigration Violation

  • If entered without inspection or without permission, check 'EWI'
  • 245(i) Eligibility

  • NACARA Eligibility

  • ABC Class action settlement agreement
  • U-Visa/T-Visa/VAWA Eligibility

  • Asylum Eligibility

  • Criminal History

  • Date, place, crime, time sentenced, served.
  • Removal proceedings

  • Bond/Detention

  • The NTA (Notice to Appear) is the document that indicates why the government believes you can be removed from the U.S. Learn more at https://www.immigrantlc.org/resource/know-your-rights-how-to-read-your-nta/