Overseas Matchmakers

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IMBRA – BACKGROUND INFORMATION DISCLOSURE FORM

IMBRA FORM

The background information below is required under the International Marriage Broker Regulation Act (IMBRA) of 2005.

This information provided will be translated into Spanish and provided to the women that you wish to meet and later keep in contact with.

If you answer “YES” to any of the questions below, a DETAILED STATEMENT OF EXPLANATION AND INFORMATION, OR ALTERNATIVELY ANY NECESSARY OPTIONAL DOCUMENTATION via Electronic Attachment along with any additional documentation.

NOTE: -IMBRA mandates that if a petitioner has a record of certain violent or sexual crimes, they are immediately disqualified from petitioning. Exceptions to these statutes require a waiver: However, waivers are hardly ever granted. (Specified List of Crimes)
-IMBRA limits the number of K1 visas an individual U.S. The petitioner can apply for in their lifetime to two.

What is your Full Name?

First

Middle

Last

Email:

Confirm Email

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

When is your Birthday

Do you have any temporary or permanent civil protection order or restraining order issued against you?

If yes, please explain:

Do you have any Federal, State, or local arrest or conviction for homicide, murder, manslaughter, assault, battery, domestic violence, rape, sexual assault, 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?

If yes, please explain:

Do you have any Federal, State, or local arrest or conviction for a. solely, principally, or incidentally engaging in prostitution; b. a direct or indirect attempt to procure prostitutes or persons for the purpose of prostitution; or c. receiving, in whole or in part, of the proceeds of prostitution.

If yes, please explain:

Do you have any Federal, State, or local arrest or conviction for offenses related to controlled substances or alcohol?

If yes, please explain:

Are you currently married?

If yes, please explain:

Were you previously married?

If yes explain how many times, how the previous marriages were terminated and the date of termination, and whether you have sponsored an alien to whom you were engaged or married:

List all states and countries in which you have resided since 18 years of age:

Are there any records under your name in the following site: http://www.nsopr.gov?

If yes, please explain:

By submitting this document, I certify under penalty of perjury that the information I have provided is true, accurate, and complete. I authorize OverseasMatchmakers and its partner site, Destino Cupido, to share this information in any format with interested foreign women. I confirm that I have provided any required supporting documentation for the questions answered “Yes” above. I voluntarily waive any privacy rights related to the release of this information. Furthermore, I release and discharge OverseasMatchmakers and Destino Cupido from any and all liability arising from the release or use of this information, as well as from any services, benefits, or assistance provided by the company.

I Agree Consented

Date Completed

Overseas Matchmakers

– Find a Latina –

With Colombia´s #1 Matchmaker

Maria J. Bueno

Contact Information

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CHAT WITH US

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Barranquilla – Colombia

Open Office Hours

Monday – Friday 2PM- 6PM
Saturday 10- 2PM
We´re Closed Sunday – Holidays

Causes We Support

Let´s Get Started

Overseas Matchmakers

– Find a Latina –

With Colombia´s #1 Matchmaker

Maria J. Bueno

Contact Information



CHAT WITH US



Barranquilla – Colombia

Open Office Hours

Monday – Friday 2PM- 6PM
Saturday 10- 2PM
We´re Closed Sunday – Holidays