What is your full or complete name?
- Mr. Smith
- 1235 Madison Avenue
- Robert
- Mr. Robert Smith
Have you ever used any other names?
- My last name is Smith
- My name is Robert
- I took my husband’s name after marriage
- Yes I would like to change my name
What is your Date of Birth?
- April 23th, 1967
- I’m 42 years old
- 4 years
- 1944
Where were you born?
- 45 years old
- Veracruz, Mexico
- Next month
- I took the bus
Are either of your parents United States Citizens?
- Yes my parents are both living in the Unites States
- Yes my parents want to be United States Citizens
- No my parents are not currently applying to be United States Citizens
- Yes my parents have U.S. citizenship status
Where are you currently living?
- Los Angeles, California
- From India
- 6 feet 2 inches
- I have 2 children
Who do you live with?
- I live in Arizona
- My wife and two children
- I work in a restaurant
- I am from El Salvador
Are you a member of any type of clubs or organizations?
- No I am not an organized person
- Yes I am currently working
- Yes I belong to the Small Business Association
- No I am not currently going to school
When was your last trip outside the United States?
- 5 days a week
- Next month
- Vietnam
- In August 2013
How many days have you been outside the US in the last 5 years?
- 2008
- China
- 2 years ago
- 12 days