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1.      Background information, signed and certified by the client, describing and attesting to the following personal information:

a.       Any temporary or permanent civil protection order or restraining order issued against the client.

b.      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.

c.       Any Federal, State, or local arrest or conviction of the 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.

d.      Any Federal, State, or local arrest or conviction of the client for offenses related to con­trolled substances or alcohol.

e.       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, and whether the client has previously sponsored an alien to whom the client was engaged or married.

f.        The ages of any of the client’s children who are under the age of 18.

g.       All States and countries in which the client has resided since the client was 18 years of age.

Update 021008