Buying Need a web input form made must be a php expert

Hi guys i have a client that needs to have a page where his clients fill out the following list of questions

Family Name:
First Name:
Middle Name:
Male: Female:
Date Of Birth:
Citizenship / Nationally:
All other names ever used:
City & Country of Birth:
U.S Social Security Number:
Fathers Family Name:
Fathers First Name:
Fathers Date of Birth:
Fathers City and Country of Birth:
Fathers Current City and Country of Residence:
Mothers Family Name:
Mothers First Name:
Mothers Date of Birth:
Mothers City and Country of Birth:
Mothers Current City and Country of Residence:
Current Husband Or Wife Family Name For Wife give maiden name (if
none state: None)
First name:
Date of Birth:
City & Country of Birth:
Date Of Marriage:
Place of marriage:
EX - Former Husband Or Wife Family Name For Wife give maiden name
(if none state: None)
First name:
Date of Birth:
Date and Place of marriage:
Date and place of termination of marriage:

(Your last 5 years of residence starting with present)
Street and Number:
City:
State or Providence:
Country:
From Month:
From Year:
Street and Number:
City:
State or Providence:
Country:
From Month:
From Year:
To Month:
To Year:
Street and Number:
City:
State or Providence:
Country:
From Month:
From Year:
To Month:
To Year:
Street and Number:
City:
State or Providence:
Country:
From Month:
From Year:
To Month:
To Year:
Street and Number:
City:
State or Providence:
Country:
From Month:
From Year:
To Month:
To Year:

Last address outside United states if been more then one year:
Street and Number:
City:
State or Providence:
Country:
From Month:
From Year:
To Month:
To Year:

(Employment last 5 years starting with present)
Full name and address of employer:
Occupation:
From Month:
From Year:
Full name and address of employer:
Occupation:
From Month:
From Year:
To Month:
To Year:
Full name and address of employer:
Occupation:
From Month:
From Year:
To Month:
To Year:
Full name and address of employer:
Occupation:
From Month:
From Year:
To Month:
To Year:


then once client hits submit , it needs to input automaticlly into a pdf file http://www.uscis.gov/files/form/g-325a.pdf then it auto saves on the server


i can explain in more detail but this should give you an idea, get back to me with cost and time frame and we can then go from there thanks, josh

 

i can create such a form

 

Sold me a worthless traffic site, refused to give a refund.

 

In regards to the quoted text (your post) below... Is this a Government Client?

I am asking this because the form that you have mentioned is on a .gov website, thus leaving me to assume that it is a Government Client.

This is a U.S Citizen/Immigration application form. Could you please explain your "clients" intent for this; because it seems a little suspicious.

 

No its not a gov client its a visa attorney client, why is that strange?