Filling Out the Immigration Law Application &
Getting Started

There is a $40.00 non-refundable processing fee to submit your application.

You may pay using a debit or credit card in the space provided in the application below, or by personal check or money order made out to the “Moderate Means Program.”

If you have reviewed “Income Guidelines to Qualify” and you have determined that you do qualify, download and fill out this application.

Immigration Law Application

Getting Started with the Application

In this application, you will need to provide the following information and documents:

  1. You are referred to in this application as a petitioner. You begin the application by filling in your contact and employment information.
  2. Next, you’ll have a chance to list special considerations regarding your income—such as child support, or spousal support that you may be paying.
  3. Then there is “Opposing Party Information.” This is the information about the person with whom you are having a legal problem. We need information on this opposing party, where they work, and if they have a lawyer. This is not always available to the applicants or they don’t have the information.

    If you are not able to provide all of the information for this section, do not worry. Fill it in as best you can. Many times your attorney can find out this information.

  4. Next, we need to know about the specific immigration law problem that you are having. Fill in this information as best you can.
  5. Finally, please read the “Statement of Understanding” and sign and date the application.
  6. If you are getting monetary support to help you pay for this program from somebody else, this person is called a co-signer, and we need information about this person, too.

    Please have your co-signer fill out the following form for you, and return it with your application:

    Co-Signer Addendum

Additional Documents That May Be Needed

Both the co-signer (if you are using one) and applicant (you) must also supply copies of one of the following items to prove income:

  • The last 6-weeks of pay stubs
  • Unemployment Awards letters
  • Social Security documentation

If you do not have one of the above items, you should call our office. We may be able to suggest something else.

(925) 677-0234

Where to Send Your Fee & Application

When you are done with your application, attach your documents and your $40.00 processing fee and mail to:

Moderate Means Program
Contra Costa County Bar Association
2300 Clayton Road, Suite 520
Concord, CA 94520

Or fax to: (925) 686-9867



You are the petitioner and the one who is filling out the forms and requesting to participate in this program.



A co-signer is someone (possibly a friend or family member) who has agreed to pay for your attorney fees if you are unable to do so.

A Co-signer must also include proof of their income, as described on these pages. Plus, your co-signer does not have the same income restrictions as you do, and can make more than the Level guidelines described on these pages.


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