I-864 Ins Toc

Instructions for Affidavit of Support
Under Section 213A of the INA
Department of Homeland Security
U.S. Citizenship and Immigration Services

USCIS
Form I-864

OMB No. 1615-0075
Expires 03/31/2020

What is the Purpose of Form I-864?
This affidavit is required for most family-based intending immigrants and some employment-based intending immigrants
as part of the public charge inadmissibility determination under section 212(a)(4) of the Immigration and Nationality Act
(INA). Failure to submit a sufficient Form I-864, when required, will result in a finding that the intending immigrants are
inadmissible under section 212(a)(4) of the INA.

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This affidavit is a contract between you, the sponsor, and the U.S. Government. Completing and signing Form I-864
makes you the sponsor. You must show on this affidavit that you have enough income and/or assets to maintain the
intending immigrants and the rest of your household at 125 percent of the Federal Poverty Guidelines (or at 100 percent
of the Federal Poverty Guidelines if you are an active duty member of the U.S. Armed Forces, other than active duty for
training, petitioning for your spouse or child). By signing this affidavit, you are agreeing to use your income and/or assets
to support the intending immigrants named in this affidavit if it becomes necessary.

How is Form I-864 Used?

This contract will be used to determine whether you have enough income and/or assets to maintain the intending
immigrants at 125 percent of the Federal Poverty Guidelines for your household size (or at 100 percent of the Federal
Poverty Guidelines if you are an active duty member of the U.S. Armed Forces, other than active duty for training,
petitioning for your spouse or child). The U.S. Government will consider your income and assets listed on this affidavit
as available for the support of the intending immigrants in determining whether the intending immigrants are eligible for
means-tested public benefits.
Means-tested Public Benefits

The submission of this affidavit may make the sponsored immigrant ineligible for certain Federal, state, or local meanstested public benefits, because an agency that provides means-tested public benefits will consider your income and/or
assets as available to the sponsored immigrant when determining the sponsored immigrant’s eligibility for the meanstested public benefit program.
If an immigrant sponsored in this affidavit receives any Federal, state or local means-tested public benefits, the agency
providing the benefit may request that you reimburse the agency for the cost of those benefits. That agency can sue you if,
upon request, you do not reimburse the benefit granting agency for the cost of the means-tested public benefits provided.
Not all benefits are considered as means-tested public benefits. See the contract in Part 9. Sponsor’s Contract,
Statement, Contact Information, Certification, and Signature of Form I-864 for a list of benefits that are not
considered means-tested public benefits.

Who Needs to Submit Form I-864?
The following intending immigrants are required by law to submit Form I-864 completed by the petitioner to obtain an
immigrant visa overseas or to adjust status to that of a lawful permanent resident of the United States:
1. All immediate relatives of U.S. citizens (spouses, unmarried children under 21 years of age, and parents of U.S.
citizens 21 years of age and older);

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This includes certain children immigrating based on adoption who will not acquire U.S. citizenship under section 320
of the INA upon admission to the United States (but may acquire U.S. citizenship later). Form I-864 or Form I-864EZ
is required if the child is classified:
A. Under INA section 101(b)(1)(F) on the basis of an approved Form I-600, but the child will be adopted in the
United States (if the petitioner is married, this includes a child who will not be adopted by the spouse until after
the child’s admission to the United States);
B. Under INA section 101(b)(1)(G) on the basis of an approved Form I-800, but the child will be adopted in the
United States (if the petitioner is married, this includes a child who will not be adopted by the spouse until after
the child’s admission to the United States); or

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C. If a child classified under INA section 101(b)(1)(F) was adopted by the petitioner (and spouse, if any) abroad,
but neither adoptive parent personally saw and observed the child before or during the adoption proceeding, the
child will be considered to be coming to be adopted in the United States unless the adoptive parents establish
that, under the law of the state of residence, the foreign adoption will be recognized without the need for a “readoption” or similar formal court proceeding.
See the Form I-864EZ Instructions for when Form I-864EZ can be submitted instead of Form I-864.
2. All family-based preference immigrants (unmarried sons and daughters of U.S. citizens, spouses and unmarried sons
and daughters of lawful permanent residents, married sons and daughters of U.S. citizens, and brothers and sisters of
U.S. citizens 21 years of age and older); and
3. Employment-based preference immigrants in cases only when a U.S. citizen, lawful permanent resident, or U.S.
national relative filed the immigrant visa petition or such relative has a significant ownership interest (five percent or
more) in the entity that filed the petition.

Are There Exceptions to Who Needs to Submit Form I-864?

In general, an applicant for an immigrant visa or adjustment of status who is exempt from the public charge ground of
inadmissibility at the time of his or her immigrant visa interview or application for adjustment of status is not required to
submit Form I-864.
In addition, the following intending immigrants also do not need to file Form I-864:

1. Any intending immigrant who has earned or can receive credit for 40 qualifying quarters (credits) of work in the
United States. In addition to their own work, intending immigrants may be able to secure credit for work performed
by a spouse during marriage and by their parents while the immigrants were under 18 years of age. The Social
Security Administration (SSA) can provide information on how to count quarters of work earned or credited and how
to provide evidence of such. See the SSA website at https://www.ssa.gov/myaccount/ for more information;
2. Any intending immigrant who will, upon admission, acquire U.S. citizenship under section 320 of the Immigration
and Nationality Act (INA), as amended by the Child Citizenship Act of 2000 (CCA); This includes certain children
immigrating based on adoption;
3. Self-petitioning widows or widowers who have an approved Form I-360, Petition for Amerasian, Widow(er), or
Special Immigrant; and
4. Self-petitioning abused spouses and children who have an approved Form I-360, Petition for Amerasian, Widow(er),
or Special Immigrant.
NOTE: Self-petitioning abused parents of U.S. citizen sons and daughters who have an approved Form I-360 do not need
to file Form I-864.

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To be Eligible to be a Sponsor for an Affidavit of Support, you must generally be:
1. A citizen or national of the United States or a lawful permanent resident;
2. At least 18 years old;
3. Domiciled in any of the several States of the United States, the District of Columbia, or any territory or possession of
the United States;
4. The petitioner for the alien requesting the immigration benefit; and
5. Able to demonstrate the means to maintain the intending immigrant(s) listed on this affidavit and your household and
at an annual income equal to at least 125 percent of the Federal Poverty Guidelines (or at least 100 percent of the
Federal Poverty Guidelines for active duty members of the U.S. Armed Forces, other than active duty for training,
petitioning for a spouse or child).

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To be eligible to be a joint sponsor, you must meet all of the above requirements for sponsorship except for being the
petitioner for the alien requesting the immigration benefit.
To be eligible to be a substitute sponsor, you must meet all of the above requirements for sponsorship except for being
the petitioner for the alien requesting the immigration benefit, and must be the sponsored alien’s spouse, parent, motherin-law, father-in-law, sibling, child (if at least 18 years of age), son, daughter, son-in-law, daughter-in-law, sister-in-law,
brother-in-law, grandparent, grandchild or legal guardian.
Sponsor and Beneficiary Liability

Under section 213A of the Act, if the individual you are sponsoring receives means-tested public benefits, upon request,
you must reimburse the agency that provides the benefits, and the agency that provides the benefits may be able to sue you
to recover the cost of the benefits provided if you do not reimburse the agency.
In addition to that provision, your income or assets may be combined with the income or assets of the sponsored alien
in determining whether that individual is eligible for Food Stamps, 7 U.S.C. 2014(i)(1); Supplemental Security Income
(SSI), 42 U.S.C. 1382j; and Temporary Assistance for Needy Families (TANF), 42 U.S.C. 608; or other means-tested
public benefits.
Documentation of Income and Resources

A foreign national applying for SSI must make available to the Social Security Administration documentation concerning
his or her income and resources and those of the sponsor, including information that was provided in the corresponding
application.
A foreign national applying for TANF or Food Stamps must make similar information available to the State public
assistance agency.
The U.S. Secretary of Health and Human Services and the U.S. Secretary of Agriculture are authorized to obtain copies
of any such documentation submitted to U.S. Citizenship and Immigration Services, (USCIS) or the U.S. Department of
State and to release such documentation to a State public assistance agency.
Liability Due to Misinformation
Sections 1621(e) of the Social Security Act and subsection 5(i) of the Food Stamp Act also provide that a foreign national
and his or her sponsor shall be “jointly and severally liable” to reimburse any SSI, TANF, or Food Stamp benefits that are
incorrectly paid because of misinformation provided by a sponsor or because of a sponsor’s failure to provide information,
except where the sponsor was without fault or where good cause existed. This means the foreign national and sponsor are
each liable for the full amount of any reimbursement because of misinformation as described above.
Incorrect payments that are not repaid will be withheld from any subsequent payments for which you or your sponsor are
otherwise eligible under the Social Security Act or Food Stamp Act.

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These provisions do not apply to SSI, TANF, or Food Stamp eligibility of foreign nationals admitted as refugees, asylees,
or Cuban/Haitian entrants as defined in section 501(e) of P.L. 96-422, and to dependent children of the sponsor or
sponsor’s spouse.

Specific Requirements
Who Completes and Signs Form I-864?
A sponsor completes and signs Form I-864. A sponsor is required to be at least 18 years of age and domiciled in
the United States, or its territories or possessions (See Part 4. Information About You (Sponsor) section of these
Instructions for more information on domicile). The petitioning sponsor must sign and complete Form I-864, even if a
joint sponsor also submits an I-864 to meet the income requirement. The list below identifies who must become sponsors
by completing and signing a Form I-864, when it is required.

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1. The U.S. citizen, lawful permanent resident, or U.S. national who filed Form I-129F, Petition for Alien Fiancé(e), for a
fiancé(e); Form I-130, Petition for Alien Relative, for a family member; Form I-600, Petition to Classify Orphan as an
Immediate Relative, for an orphan; or Form I-800, Petition to Classify Convention Adoptee as an Immediate Relative,
for a Convention adoptee.
NOTE: If you must file Form I-864 in connection with a Form I-600, you will typically file with the Department of
State as part of your child’s immigrant visa application.
2. The U.S. citizen, lawful permanent resident, or U.S. national who filed Form I-140, Immigrant Petition for Alien
Worker, for a spouse, parent, son, daughter, or sibling who:
A. Has a significant ownership interest (five percent or more) in the business which filed the employment-based
immigrant visa petition; or
B. Is related to the intending immigrant as a spouse, parent, son, daughter, or sibling.
What Are the Income Requirements?

To qualify as a sponsor, you must demonstrate that your income is at least 125 percent of the current Federal Poverty
Guidelines for your household size. The Federal poverty line, for purposes of this affidavit, is updated annually and can
be found on Form I-864P, Poverty Guidelines, at www.uscis.gov/I-864P.
If you are on active duty in the U.S. Armed Forces, including the Army, Marines, Navy, Air Force, or Coast Guard, and
you are sponsoring your spouse or minor child, you only need to have an income of 100 percent of the Federal Poverty
Guidelines for your household size. This provision does not apply to joint or substitute sponsors.
How Do I Count Household Size?
Your household size includes you and the following individuals, no matter where they live:
A. Any spouse;
B. Any dewpendent children under 21 years of age;
C. Any other dependents listed on your most recent Federal income tax return;
D. All persons being sponsored in this affidavit of support; and
E. Any immigrants previously sponsored with Form I-864 or Form I-864 EZ, Affidavit of Support Under Section
213A of the INA, whom you are still obligated to support.
If necessary to meet the income requirements to be a sponsor, you may include additional relatives (adult children,
parents, or siblings) as part of your household size as long as they have the same principal residence as you and promise to
use their income and resources in support of the intending immigrants.

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What if I Cannot Meet the Income Requirements?
If your individual income alone is not sufficient to meet the requirement for your household size, the intending immigrants
will be ineligible for an immigrant visa or adjustment of status, unless you can meet the requirement by using any
combination of the following:
1. Income from any relatives or dependents living in your household or dependents listed on your most recent Federal
income tax return who signed Form I-864A, Contract Between Sponsor and Household Member;
2. Income from the intending immigrant, if that income will continue from the same source after immigration, and if the
intending immigrant is currently living in your residence. If the intending immigrant is your spouse, his or her income
can be counted regardless of current residence, but it must continue from the same source after he or she becomes a
lawful permanent resident;

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3. The value of your assets, the assets of any household member who has signed Form I-864A, or the assets of the
intending immigrants; or
4. A joint sponsor whose income and/or assets equal at least 125 percent of the Federal Poverty Guidelines. (See the
What is a Joint Sponsor section of these Instructions for more information.)
How Can My Relatives and Dependents Help Me Meet the Income Requirements?

You may use the income of your spouse and/or any other relatives living in your residence if they are willing to be jointly
responsible with you for the intending immigrants you are sponsoring. If you have any unrelated dependents listed on
your Federal income tax return you may include their income regardless of where they reside.
The income of such household members and dependents can be used to help you meet the income requirements if they
complete and sign Form I-864A, Contract Between Sponsor and Household Member, and if they are at least 18 years of
age when they sign the Form I-864A.
Can the Intending Immigrant Help Me Meet the Income Requirements?

If certain conditions are met, an intending immigrant’s income can help you meet the income requirement. If the
intending immigrant is your spouse, his or her income can be included if it will continue from the same source after he or
she obtains lawful permanent resident status.
If the intending immigrant is another relative, there are two requirements:

1. The income must be continuing from the same source after he or she obtains lawful permanent resident status; and
2. The intending immigrant must currently live with you in your residence.
Evidence must be provided to support both requirements, however, an intending immigrant whose income is being used
to meet the income requirement does not need to complete Form I-864A, Contract Between Sponsor and Household
Member, unless the intending immigrant has a spouse and/or children immigrating with him or her. In this instance, the
contract relates to support for the spouse and/or children.
Does Receipt of Means-Tested Public Benefits Disqualify Me from Being a Sponsor?
No. Receipt of means-tested public benefits does not disqualify you from being a sponsor. However, means-tested public
benefits cannot be counted as income for the purposes of meeting the income requirement.
How Can I Use Assets to Qualify?
You may use assets to supplement income if the consular or immigration officer is convinced that the monetary value of
the asset could reasonably be made available to support the sponsored immigrant and converted to cash within one year
without undue harm to the sponsor or his or her family members. You may not include an automobile unless you show
that you own at least one working automobile that you have not included.

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What is a Joint Sponsor?
If the person who is seeking the immigration of one or more of his or her relatives cannot meet the income requirements, a
joint sponsor who can meet the requirements may submit Form I-864 to sponsor all or some of the family members.
A joint sponsor can be any U.S. citizen, lawful permanent resident, or U.S. national who is at least 18 years of age,
domiciled in the United States, or its territories or possessions, and willing to be held jointly liable with the petitioner
for the support of the intending immigrants. A joint sponsor does not have to be related to the petitioning sponsor or the
intending immigrants.
If the first joint sponsor completes Form I-864 for some rather than all the family members, a second qualifying joint
sponsor will be required to sponsor the remaining family members. There may be no more than two joint sponsors. A
joint sponsor must be able to meet the income requirements for all the persons he or she is sponsoring without combining
resources with the petitioning sponsor or a second joint sponsor. Any dependents applying for an immigrant visa or
adjustment of status more than six months after immigration of the intending immigrants must be sponsored by the
petitioner but may be sponsored by an original joint sponsor or a different joint sponsor.

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Even if more than one Form I-864 is submitted for an intending immigrant, the petitioning sponsor remains legally
accountable for the financial support of the sponsored immigrant along with the joint sponsors. The petitioning sponsor
must complete and submit a signed Form I-864 for the intending immigrants even if a joint sponsor will be used. The
petitioning sponsor must also provide his or her Federal income tax return for the most recent tax year with supporting tax
documents unless otherwise not required to file a Federal income tax return for the most recent tax year.
What Is a Substitute Sponsor?

A substitute sponsor is a sponsor who is completing Form I-864 on behalf of an intending immigrant whose original Form
I-130 petitioner has died after Form I-130 was approved, but before the intending immigrant obtained legal permanent
residence.
The substitute sponsor must be related to the intending immigrant in one of the following ways: spouse, parent, motherin-law, father-in-law, sibling, child (at least 18 years of age), son, daughter, son-in-law, daughter-in-law, brother-in-law,
sister-in-law, grandparent, grandchild, or legal guardian. The substitute sponsor must also be a U.S. citizen, lawful
permanent resident, or U.S. national.
If you are a substitute sponsor, you must indicate that you are related to the intending immigrant in one of the ways listed
above and include evidence proving that relationship. The beneficiary must also file this affidavit along with a typed or
printed statement explaining the reasons why the Form I-130 visa petition should be reinstated, having been revoked
following the petitioner’s death. The beneficiary must also include a copy of the Form I-130 approval notice.
How Long Does My Obligation as a Sponsor Continue?
Your obligation to support any immigrants you are sponsoring on this Form I-864, Affidavit of Support, will continue until
the sponsored immigrants become U.S. citizens, or have worked or can be credited with 40 qualifying quarters of work in
the United States under the Social Security Act.
Although 40 qualifying quarters of work (credits) generally equates to 10 years of work, in certain cases the work of a
spouse or parent adds qualifying quarters. The Social Security Administration can provide information on how to count
qualifying quarters (credits) of work.
The obligation also ends if you or the sponsored immigrant dies, if the sponsored immigrant abandons or loses lawful
permanent resident status and departs the United States, or if the sponsored immigrant obtains lawful permanent resident
status on a new basis in removal proceedings based on a new affidavit of support (if such an affidavit of support is
required). Divorce does not end your sponsorship obligation.
You may withdraw your affidavit of support at any time until a decision is issued on the applicant’s application for an
immigrant visa or adjustment of status. The withdrawal must be in writing, must include your signature, and must be
received before the final decision is issued. A withdrawal may not be retracted.

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Do I Need to Submit a Separate Affidavit for Each Family Member?
Yes. You must submit a separate Form I-864 for each intending immigrant you are sponsoring. You may submit
photocopies if you are sponsoring more than one intending immigrant listed on the same affidavit of support.
Separate affidavits of support are required for intending immigrants for whom different Form I-130, Form I-600, or
Form I-800 family-based petitions were filed. For instance, if you are sponsoring both parents, each will need an original
affidavit of support and accompanying documentation since you were required to submit separate Form I-130 visa
petitions for each parent. Often a spouse or minor children obtain visas or adjust status as dependents of a relative, based
on the same visa petition. If you are sponsoring such dependents, you only need to provide a photocopy of the original
Form I-864, as long as these dependents are immigrating at the same time as the principal immigrant or within six months
of the time he or she immigrates to the United States. You do not need to provide copies of the supporting documents for
each of the photocopied Form I-864s.

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General Instructions

U.S. Citizenship and Immigration Services (USCIS) provides forms free of charge through the USCIS website. In order
to view, print, or fill out our forms, you should use the latest version of Adobe Reader, which you can download for free
at http://get.adobe.com/reader/. If you do not have Internet access, you may order USCIS forms by calling the USCIS
Contact Center at 1-800-375-5283. The USCIS Contact Center provides information in English and Spanish. For TTY
(deaf or hard of hearing) call: 1-800-767-1833.
Signature. Form I-864 must be notarized by a notary public. Each affidavit must be properly signed before a notary
public and filed. For all signatures on this affidavit, USCIS will not accept a stamped or typewritten name in place of a
signature. You must be at least 18 years of age to meet the definition of a sponsor and sign Form I-864. A legal guardian
may also sign Form I-864 for a mentally incompetent person.
If you are under a guardianship, your legal guardian may print your name and sign Form I-864 for you. Legal guardian
includes any individual who is appointed and authorized by law to protect your estate as a result of your incapacity. The
legal guardian must present proof of the appointment as legal guardian of your estate and a copy of an order from the
appointing court or agency specifically permitting the guardian to make your income and assets available for the support
of the sponsored immigrant.
If the affidavit is not signed or if the requisite signature on the affidavit is not valid, USCIS will reject the request. See
8 CFR 103.2(a)(7)(ii)(A). If USCIS accepts a request for adjudication and determines that it has a deficient signature,
USCIS will deny the request.
Validity of Signatures. USCIS will consider a photocopied, faxed, or scanned copy of the original handwritten signature
valid for filing purposes. The photocopy, fax, or scan must be of the original document containing the handwritten ink
signature.
Filing Fee. There is no filing fee to file Form I-864 with USCIS. For information on processing fees when filing with the
U.S. Department of State (DOS), see www.travel.state.gov.
Evidence. At the time of filing, you must submit all evidence and supporting documents listed in these Instructions with
your affidavit. If you fail to submit required evidence, USCIS or DOS may reject or deny your affidavit for failure to
submit requested evidence or supporting documents in accordance with 8 CFR 103.2(b)(1) and these Instructions.

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Biometric Services Appointment. USCIS may require that you appear for an interview or provide biometrics
(fingerprints, photograph, and/or signature) at any time to verify your identity, obtain additional information, and conduct
background and security checks, including a check of criminal history records maintained by the Federal Bureau of
Investigation (FBI), before making a decision on your application, petition, or request. After USCIS receives your
contract and ensures it is complete, we will inform you if you need to attend a biometric services appointment. If an
appointment is necessary, the notice will provide you the location of your local or designated USCIS Application Support
Center (ASC) and the date and time of your appointment or, if you are currently overseas, instruct you to contact a U.S.
Embassy, U.S. Consulate, or USCIS office outside the United States to set up an appointment.
If you are required to provide biometrics, at your appointment you must sign an oath reaffirming that:
1. You provided or authorized all information in the affidavit;

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2. You reviewed and understood all of the information contained in, and submitted with, your affidavit; and
3. All of this information was complete, true, and correct at the time of filing.

Copies. You should submit legible photocopies of documents requested, unless the Instructions specifically state that you
must submit an original document. USCIS may request an original document at the time of filing or at any time during
processing of an application, petition, or request. If USCIS requests an original document from you, it will be returned to
you after USCIS determines it no longer needs your original.
NOTE: If you submit original documents when not required or requested by USCIS, your original documents may be
immediately destroyed after we receive them.
Translations. If you submit a document with information in a foreign language, you must also submit a full English
translation. The translator must sign a certification that the English language translation is complete and accurate, and
that he or she is competent to translate from the foreign language into English. The certification must also include the
translator’s signature, printed name, the signature date, and the translator’s contact information.
How to Fill Out Form I-864

1. Type or print legibly in black ink.

2. If you need extra space to complete any item within this affidavit, use the space provided in Part 12. Additional
Information or attach a separate sheet of paper. Type or print your name and Alien Registration Number (A-Number)
(if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer
refers; and sign and date each sheet.
3. Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been
married and the question asks “Provide the name of your current spouse”), type or print “N/A,” unless otherwise
directed. If your answer to a question which requires a numeric response is zero or none (for example, “How many
children do you have” or “How many times have you departed the United States”), type or print “None,” unless
otherwise directed.

Specific Instructions
Part 1. Basis for Filing Affidavit of Support
Provide your full name (the sponsor) in the space provided, then select the Item Number that reflects your basis for filing
Form I-864.
Item Number 1.a. Select this box if you are the petitioner who is filing or who has already filed Form I-129F, Petition
for Alien Fiancé(e), for a fiancé(e); Form I-130, Petition for Alien Relative, for a family member; Form I-600, Petition to
Classify Orphan as an Immediate Relative, for an orphan; or Form I-800, Petition to Classify Convention Adoptee as an
Immediate Relative, for a convention adoptee.
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Age Limitations for Spousal Relationships Involving a Minor
Form I-864 can only be signed by individuals who are 18 years of age or older at the time of submission. Even if your
spouse is filing an application to adjust status based on a Form I-130 you filed on your spouse’s behalf, you must be
at least 18 years of age in order to sponsor your spouse. A joint sponsor 18 years of age or older cannot remedy your
inability to execute a Form I-864 due to being under 18 years of age.
Item Number 1.b. Select this box if you are filing or have filed Form I-140, Immigrant Petition for Alien Worker, for
your husband, wife, father, mother, child, adult son or daughter, brother, or sister and indicate your relationship to the
beneficiary in the space provided.
Item Number 1.c. Select this box if you have an ownership interest of at least five percent in a business, corporation, or
other entity that filed or is filing Form I-140 for your husband, wife, father, mother, child, adult son or daughter, brother,
or sister. Indicate the name of the business you have an ownership interest in, and your relationship to the beneficiary in
the spaces provided.

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Item Number 1.d. Select this box if you are the only joint sponsor. A joint sponsor is a sponsor who is willing to submit
an affidavit of support and accept joint and several liability with the petitioning sponsor or substitute sponsor, in any case
in which the petitioning sponsor’s or substitute sponsor’s household income is not sufficient.
Item Number 1.e. Select this box if you are either of two joint sponsors.

A joint sponsor does not have to be related to the intending immigrant. Indicate whether you are the only joint sponsor or
one of two joint sponsors. Check with the petitioning sponsor or the intending immigrant if you are not certain.
Item Number 1.f. Select this box if you are the substitute sponsor. A substitute sponsor is a sponsor who is completing
Form I-864 on behalf of an intending immigrant whose original Form I-130 petitioner has died after the Form I-130 was
approved, but before the intending immigrant obtained lawful permanent residence. The substitute sponsor must be
related to the intending immigrant in one of the following ways: spouse, parent, mother-in-law, father-in-law, sibling,
child (at least 18 years of age), son, daughter, son-in-law, daughter-in-law, brother-in-law, sister-in-law, grandparent,
grandchild, or legal guardian. The substitute sponsor must also be a U.S. citizen, lawful permanent resident, or U.S.
national. If you are a substitute sponsor, you must sponsor each intending immigrant.
Part 2. Information About the Principal Immigrant

The principal immigrant is the intending immigrant who is the primary beneficiary of the visa petition.
Item Numbers 1.a. - 1.c. Name. Provide the full name of the principal immigrant.

Item Numbers 2.a. - 2.i. Mailing Address. Provide the mailing address of the principal immigrant.
Item Number 3. Country of Citizenship or Nationality. Provide the country of citizenship or nationality of the
principal immigrant.
Item Number 4. Date of Birth. Provide the date of birth of the principal immigrant in mm/dd/yyyy format.
Item Number 5. Gender. Provide the principal immigrant’s gender, male or female.
Item Number 6. Alien Registration Number (A-Number) (if any). An Alien Registration Number (A-Number) is a
number assigned by the former Immigration and Naturalization Service (INS) or USCIS. People with A-Numbers can
locate the number on their INS or USCIS-issued documentation. If the intending immigrants you are sponsoring have not
previously been in the United States or have only been in the United States as tourists, they may not have A-Numbers.

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Item Number 7. USCIS Online Account Number (if any). If you have previously filed an application, petition, or
request using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)),
provide the USCIS Online Account Number you were issued by the system. You can find your USCIS Online Account
Number by logging in to your account and going to the profile page. If you previously filed certain applications, petitions,
or requests on a paper form via a USCIS Lockbox facility, you may have received a USCIS Online Account Access Notice
issuing you a USCIS Online Account Number. If you received such a notice, your USCIS Online Account Number can be
found at the top of the notice. If you were issued a USCIS Online Account Number, enter it in the space provided. The
USCIS Online Account Number is not the same as an A-Number.
Item Number 8. Daytime Telephone Number. Provide a daytime telephone number with area code for the principal
immigrant.

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Part 3. Information About the Immigrants You Are Sponsoring

Item Number 1. Indicate whether you are sponsoring the principal immigrant listed in Part 2. of Form I-864. Select
“No” if you are sponsoring only intending immigrants listed in Part 3., Item Numbers 4.a. - 28. and (if applicable)
in Part 12. Additional Information, and not the principal immigrant listed in Part 2. This only applies if you are
sponsoring family members in Part 3. and Part 12. Additional Information, as the second joint sponsor.
Item Number 2. Family Members Immigrating Within Six Months. The immigrant you are sponsoring (the principal
immigrant) may bring a spouse and/or children to the United States. If the spouse and/or children will travel with the
principal immigrant, or within six months of the principal immigrant’s entry into the United States and you are sponsoring
them, you should list the names and other requested information in the spaces provided in Item Number 2. If any
dependents are not immigrating, will immigrate more than six months after the principal immigrant arrives in the United
States, or you are not sponsoring them, then do not list their names here. A separate Form I-864 is required for them when
they apply for their immigrant visas.
NOTE: For Item Numbers 2. and 3., see the Do I Need to Submit a Separate Affidavit for Each Family Member
section for further explanation of sponsoring more than one intending immigrant.
Item Numbers 4.a. - 28. Family Members Immigrating More Than Six Months After the Principal Immigrant. If
you are filing this Form I-864 for the principal immigrant’s family members who are immigrating more than six months
after the principal immigrant, you should list the names and other requested information in the spaces provided in Item
Numbers 4.a. - 28.
Item Number 29. Type or print the total number of immigrants you are sponsoring on this affidavit from Item
Numbers 1.a. - 28., including any immigrants listed for these questions in Part 12. Additional Information.
Part 4. Information About You (Sponsor)
Item Numbers 1.a. - 1.c. Sponsor’s Full Name. Provide your (the sponsor’s) full name.
Item Numbers 2.a. - 3. Sponsor’s Mailing Address. Provide your (the sponsor’s) current mailing address.
Item Numbers 4.a. - 4.h. Sponsor’s Physical Address. Provide the physical address where you (the sponsor) live, if
different from your mailing address.
Item Number 5. Country of Domicile. Indicate the country where you maintain your principal residence and where you
plan to reside for the foreseeable future. If your mailing address and/or place of residence is not in the United States, but
your country of domicile is the United States, you must attach a typed or printed explanation and documentary evidence
indicating how you meet the domicile requirement. If you are not currently living in the United States, you may meet the
domicile requirement if you can submit evidence to establish that any of the following conditions apply:
1. You are employed by a certain organization.

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Some individuals employed overseas are automatically considered as domiciled in the United States because of the
nature of their employment. The qualifying types of employment include employment by:
A. The U.S. Government;
B. An American institution of research recognized by the Secretary of Homeland Security (you may find the list of
qualifying institutions at 8 CFR 316.20);
C. A U.S. firm or corporation engaged in whole or in part in the development of foreign trade and commerce with the
United States, or a subsidiary of such a firm or corporation;
D. A public international organization in which the United States participates by treaty or statute;

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E. A religious denomination having a bona fide organization in the United States, if the employment abroad involves
the individual’s performance of priestly or ministerial functions on behalf of the denomination; or
F. A religious denomination or interdenominational missionary organization having a bona fide organization in the
United States, if the individual is engaged solely as a missionary.
2. You are living abroad temporarily.

If you are not currently living in the United States, you must provide proof that your trip abroad is temporary and that
you have maintained your domicile in the United States. Examples of proof include:
A. Your voting record in the United States;

B. Records of paying U.S. state or local taxes;
C. Having property in the United States;

D. Maintaining bank or investment accounts in the United States;
E. Having a permanent mailing address in the United States; or

F. Other proof such as evidence that you are a student studying abroad or that a foreign government has authorized a
temporary stay.
3. You intend in good faith to reestablish your domicile in the United States no later than the date of the intending
immigrant’s admission or adjustment of status. You must submit proof that you have taken concrete steps to
establish you will be domiciled in the United States at a time no later than the date of the intending immigrant’s
admission or adjustment of status. Concrete steps might include accepting a job in the United States, signing a lease
or purchasing a residence in the United States, or registering children in U.S. schools. Attach proof of the steps you
have taken to establish domicile as previously described.
Item Number 6. Date of Birth. Provide your date of birth in the mm/dd/yyyy format.
Item Numbers 7. - 9. Place of Birth. Provide the city or town, state or province, and country of your birth.
Item Number 10. U.S. Social Security Number (Required). INA Section 213A(i) requires you to include your U.S.
Social Security Number on Form I-864. If you do not have a U.S. Social Security Number, you must obtain one before
submitting Form I-864. If you do not provide your information, USCIS cannot accept your Form I-864, and the intending
immigrants may not immigrate to the United States. USCIS may use your U.S. Social Security Number to verify and, if
necessary, to enforce your obligations under Form I-864.
Item Numbers 11.a. - 11.c. Citizenship or Residency. You must provide proof that you are a U.S. citizen, U.S. national,
or lawful permanent resident for joint and substitute sponsors and for relatives of employment-based immigrants who
file Form I-864. Petitioning relatives who have already filed proof of their citizenship or immigration status with Form
I-129F, Form I-130, Form I-600, or Form I-600A do not need to submit proof of their status with this affidavit.
1. Proof of U.S. citizenship or U.S. national status includes a copy of your birth certificate, certificate of naturalization,
certificate of citizenship, consular report of birth abroad to U.S. citizen parents, or a copy of the biographic data page
of your U.S. passport.
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2. Proof of lawful permanent resident status includes a photocopy of both sides of the Permanent Resident Card or Alien
Registration Receipt Card (Form I-551), or a photocopy of an unexpired temporary Form I-551 stamp in either a
foreign passport or DHS Form I-94 Arrival-Departure Record.
3. If applicable, also provide the sponsor’s A-Number in Item Number 12.
Item Number 12. Sponsor’s Alien Registration Number (if any). An Alien Registration Number (A-Number) is a
number assigned by the former INS or USCIS. People with A-Numbers can locate the number on their INS or USCISissued documentation.
Item Number 13. Sponsor’s USCIS Online Account Number (if any). If you (the sponsor) have previously filed an
application, petition, or request using the USCIS online filing system (previously called USCIS Electronic Immigration
System (USCIS ELIS)), provide the USCIS Online Account Number you were issued by the system. You can find your
USCIS Online Account Number by logging in to your account and going to the profile page. If you previously filed
certain applications, petitions, or requests on a paper form via a USCIS Lockbox facility, you may have received a USCIS
Online Account Access Notice issuing you a USCIS Online Account Number. If you received such a notice, your USCIS
Online Account Number can be found at the top of the notice. If you were issued a USCIS Online Account Number, enter
it in the space provided. The USCIS Online Account Number is not the same as an A-Number.

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Item Number 14. Military Service. Select “Yes” if you are the petitioning sponsor and on active duty in the U.S. Army,
Marines, Navy, Air Force, or Coast Guard, other than for training. If you provide evidence that you are currently on active
duty in the U.S. Armed Forces or U.S. Coast Guard and you are petitioning for your spouse and/or minor child, you will
need to demonstrate income at only 100 percent of the poverty level for your household size, instead of at 125 percent of
the poverty level. (See Form I-864P, Poverty Guidelines, for information on the poverty levels.) Select “No” if you are
not on active duty in the U.S. Armed Forces or U.S. Coast Guard. This provision does not apply to joint and substitute
sponsors.
Item Numbers 15.a. - 15.f. Sponsor’s Bank Account Information. Indicate whether you are providing information
about a checking or a savings account. Provide the account holder’s name, the name(s) of any joint account holders
(if any), the name of the banking institution, the number of your checking or savings account, and the corresponding
routing number for the account.
Part 5. Sponsor’s Household Size

Add together the number of persons for whom you are financially responsible. Some of these persons may not be residing
with you. Make sure you do not count any individual more than once. In some cases the same person could fit into two
categories. For example, your spouse, whom you would enter in Item Number 3., might also be a lawful permanent
resident for whom you have already sponsored using Form I-864 (Item Number 6.). If you included your spouse in Item
Number 3., do not include him or her again in Item Number 6.
Item Number 1. Provide the number you entered in Part 3., Item Number 29. If you or someone else is completing
Form I-864 on a computer, this box will auto-populate.
Item Number 2. This field is auto-populated to “1.”
Item Number 3. Type or print “1” if you are married. Type or print “0” if you are not married.
Item Number 4. Type or print the number of unmarried children you have who are under 21 years of age, even if you do
not have legal custody of these children. You may exclude any unmarried children under 21 years of age, if these children
have reached majority under the law of their place of domicile and you do not claim them as dependents on your Federal
income tax returns.

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Item Number 5. Type or print the number of any other dependents. You must include each and every person whom
you have claimed as a dependent on your most recent Federal income tax return, even if that person is not related to you.
Even if you are not legally obligated to support that person, you must include the person if, in fact, you did support that
person and claimed the person as a dependent.
Item Number 6. Type or print the number of lawful permanent residents whom you are currently obligated to support
based on your previous submission of Form I-864 as a petitioning, substitute, or joint sponsor, or Form I-864EZ, Affidavit
of Support Under Section 213A of the INA, as a petitioning sponsor. Include only those persons who have already
immigrated to the United States. Do not include anyone for whom your obligation to support has ended through the
sponsored immigrant’s acquisition of U.S. citizenship, death, abandonment of lawful permanent residence in the United
States, acquisition of 40 quarters of earned or credited work in the United States, or obtaining a new grant of adjustment
of status while in removal proceedings based on a new affidavit of support, if one is required.

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Item Number 7. This question gives you the option of including certain other non-dependent relatives who are living
in your residence as part of your household size. Such relatives may include your mother, father, sister, brother or adult
children, if they are living in your residence. However, the only reason to include these relatives in your household size
is if you need to include their income when you calculate your household income for purposes of meeting the income
requirement for this affidavit. To be considered, any relative included in this category must sign and submit Form I-864A,
Contract Between Sponsor and Household Member.
Item Number 8. Household Size. Add together Part 5., Item Numbers 1. - 7. and type or print the number in the space
provided. If you or someone else is completing Form I-864 on a computer, this box will auto-populate.
Part 6. Previously Executed Affidavits of Support

Note: If you executed a Form I-864 or Form I-864EZ on behalf of an intending immigrant where the support obligation
is not yet in effect, that intending immigrant is not counted as part of your household size. However, if that intending
immigrant becomes a lawful permanent resident before your support obligation on this Form I-864 becomes effective, that
sponsored immigrant is counted as part of your household size.
Item Number 1. If you executed a Form I-864 or Form I-864EZ in the past for any individuals other than those named
on this Form I-864, answer “Yes.” If you have never previously executed a Form I-864 or Form I-864EZ for any
individuals other than those named on this Form I-864, answer “No.”
1. Item Number 2. If you answered “Yes” to Item Number 1., enter the total number of individuals for whom you
have executed a Form I-864 or Form I-864EZ in the past, even if the form has not yet been adjudicated or the
individual you sponsored did not become a lawful permanent resident.
Item Number 3. For each individual you included in your answer to Item Number 2., you must provide the sponsored
individual’s name, date of birth, and Alien Registration Number. You do not need to include any individual for whom you
previously filed Form I-864 if you know that he or she:
1. Has become a United States citizen;
2. Is currently a lawful permanent resident that has worked or can be credited with 40 qualifying quarters of coverage;
3. Has abandoned or lost his or her lawful permanent resident status and departed the United States;
4. Is obtaining a new grant of adjustment of status while in removal proceedings based on a new affidavit of support, if
one is required; or
5. Has died.
Part 7. Sponsor’s Employment and Income
Item Numbers 1. - 6. Sponsor’s Employment. Select all the boxes that apply to you. You, as the sponsor, may not
rely on a household member’s income from illegal acts, such as proceeds from illegal gambling or drug sales, to meet the
income requirement even if the household member paid taxes on that income.
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Item Number 7. Current Individual Annual Income. Type or print your current, individual, earned or retirement,
annual income that you are using to meet the requirements of this affidavit and indicate the total in the space provided.
You may include evidence supporting your claim about your expected income for the current year if you believe that
submitting this evidence will help you establish ability to maintain sufficient income. You are not required to submit this
evidence, however, unless specifically instructed to do so by a U.S. government official. For example, you may include
a recent letter from your employer, showing your employer’s address and telephone number, and indicating your annual
salary. You may also provide pay stubs showing your income for the previous six months. If your claimed income
includes alimony, child support, dividend or interest income, or income from any other source, you may also include
evidence of that income.
Item Numbers 8. - 22. Current Annual Household Income. This section is used to determine the sponsor’s household
income. If your individual annual income listed in Item Number 7. is greater than 125 percent (or 100 percent if you are
on active duty in the U.S., other than active duty for training, and sponsoring your spouse or child) of the Federal Poverty
Guidelines for your household size, you do not need to include any other household member’s income. See Form I-864P
for information on the Federal Poverty Guidelines.

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To determine the filing requirements for your relatives included in Part 7., Item Numbers 8. - 19., follow the instructions
below.
1. If you included the income of your spouse listed in Part 5., Item Number 3., any child listed in Part 5., Item
Number 4., any dependent listed in Part 5., Item Number 5., or any siblings, parents, or adult children listed in
Part 5., Item Number 6., each one of these individuals must be over 18 years of age and must complete Form
I-864A.
2. If you included the income of the intending immigrant who is your spouse (he or she would be counted in
Part 5., Item Number 1.), you must provide evidence that his/her income will continue from the current source after
obtaining lawful permanent resident status. He or she does not need to complete Form I-864A unless he or she has
accompanying children.
3. If you included the income of the intending immigrant who is not your spouse, (he or she would be counted on
Part 5., Item Number 1.), evidence that his or her income will continue from a lawful source after obtaining lawful
permanent resident status must be provided and the intending immigrant must provide evidence that he or she is living
in your residence. He or she does not need to complete Form I-864A, unless he or she has an accompanying spouse
or children.
If you have listed additional household members in Part 12. Additional Information, you must include their income
and information when answering Item Numbers 20. - 22. when applicable.
Item Numbers 23.a. - 25. Federal Income Tax Return Information. You must provide either an Internal Revenue
Service (IRS) transcript or a photocopy from your own records of your Federal individual income tax return for the most
recent tax year. If you believe additional returns may help you to establish your ability to maintain sufficient income, you
may submit transcripts or photocopies of your Federal individual income tax returns for the three most recent years.
You are not required to have the IRS certify the transcript or photocopy unless specifically instructed to do so by a
Government official; a plain transcript or photocopy is acceptable.
Do not submit copies of your state income tax returns. Do not submit any tax returns that you filed with any foreign
government unless you claim that you were not required to file a Federal individual income tax return with the United
States Government and you wish to rely on the foreign return solely to establish the amount of your income that is not
subject to tax in the United States.
If you provide a photocopy of your Federal individual income tax returns, you must include a copy of each and every
Form W-2, Form 1099, and Schedule that relates to your returns. A copy of the Form W-2 and Form 1099 must be
submitted, even if the joint tax filer does not submit Form I-864A and his or her income will not be used to help meet the
sponsor’s income requirement. Do not include copies of these forms if you provide an IRS transcript of your Federal
individual income tax returns rather than a photocopy unless you filed a joint Federal income tax return with your spouse
and are qualifying using only your income.
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If you selected Part 7., Item Number 4. indicating that you are self-employed, you should have completed one of the
following forms with your Federal income tax return: Schedule C (Profit or Loss from Business), Schedule D (Capital
Gains), Schedule E (Supplemental Income or Loss), or Schedule F (Profit or Loss from Farming). You must include each
and every Form 1040 Schedule, if any, that you filed with your Federal income tax return.
As stated previously, you must submit an IRS transcript or copy of your Federal individual income tax return for the
most recent tax year. If you choose to rely on income from the three most recent tax years, you must submit an IRS
transcript or copy of your Federal individual income tax return. If you were required to file a Federal income tax return
for that tax year but did not do so, you must file all late returns with the IRS and attach an IRS transcript or copy of your
late return and submit it with Form I-864. If you were not required to file a Federal income tax return under U.S. tax
law because your income was too low, attach a typed or printed explanation. If you were not required to file a Federal
income tax return under U.S. tax law for any other reason, attach a typed or printed explanation including evidence of the
exemption and how you are subject to it. Residence outside of the United States does not exempt U.S. citizens or lawful
permanent residents from filing a U.S. Federal income tax return. See Filing Requirements in the IRS Form 1040 Filing
Instructions to determine whether you were required to file.

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For purposes of this affidavit, the line for Total Income on IRS Forms 1040 and 1040A will be considered when
determining income. For persons filing IRS Form 1040 EZ, the line for adjusted gross income will be considered.
Obtaining Tax Transcripts. You may use IRS Form 4506-T to request tax transcripts from the IRS. Complete IRS Form
4506-T with the ending date for each of your three most recent tax years listed in Item Numbers 24.a. - 24.c. Follow all
instructions for completing and filing Form 4506-T with the IRS.
Item Number 23.a. Select the box if you filed a Federal income tax return for each of the three most recent tax years and
have attached the required photocopy or transcript of your Federal income tax return for only the most recent year.
Item Number 23.b. (Optional). If applicable, select the box indicating that you have attached photocopies or transcripts
of your Federal income tax returns for your second and third most recent tax years.
Item Numbers 24.a. - 24.c. Most Recent Tax Year Total Income. Indicate the most recent tax year and your total
income for that most recent tax year. If that amount was zero, enter “zero” or “N/A” for non-applicable.
NOTE: Do not leave the boxes for Item Number 24.a. blank. Type or print the most recent tax year and your total
income for that most recent tax year. If the amount was zero, type or print “zero” or if you were not required to file a
Federal income tax return type or print “N/A” for not applicable.
Item Number 26. Credit Report (Optional). You may provide a recent U.S. credit report if you believe doing so may
help you to establish your ability to maintain sufficient income. Select the box for Item Number 26. if you are including
a credit report with your Form I-864.
Part 8. Use of Assets to Supplement Income (Optional)
Only complete Part 8. if you need to use the value of assets to meet the income requirements. If your Current Annual
Household Income (indicated in Part 7., Item Number 20.) is equal to or more than needed to meet the income
requirement as shown by the current Federal Poverty Guidelines (Form I-864P) for your household size, you do not need
to complete Part 8. If your total household income does not meet the requirement, you may submit evidence of the value
of your assets, the sponsored immigrant’s assets, and/or assets of a household member that can be used, if necessary,
to support the intending immigrants. The value of assets of all of these persons may be combined in order to meet the
necessary requirement.
Only assets that can be converted into cash within one year and without considerable hardship or financial loss to the
owner may be included. The owner of the asset must include a description of the asset, proof of ownership, and the basis
for the owner’s claim of its net cash value.

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You may include the net value of your home as an asset. The net value of the home is the appraised value of the home,
minus the sum of any and all loans secured by a mortgage, trust deed, or other lien on the home. If you wish to include
the net value of your home, then you must include documentation demonstrating that you own it, a recent appraisal by a
licensed appraiser, and evidence of the amount of any and all loans secured by a mortgage, trust deed, or other lien on the
home. You may not include the net value of an automobile unless you show that you own more than one automobile, and
that you have not included at least one automobile as an asset.
Item Numbers 1. - 4. Assets. To use your own assets, you must complete Part 8., Item Numbers 1. - 4. and submit
corresponding evidence with this affidavit. Supporting evidence must be attached to establish location, ownership, date of
acquisition, and value of any real estate holding.

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Item Numbers 5.a. - 5.b. Household Member’s Assets. To use the assets of a relative (spouse, adult son or daughter,
parent, or sibling), the relative must reside with you and have completed Form I-864A with accompanying evidence of
assets. Form I-864A and accompanying evidence of assets is submitted with Form I-864. You may use the assets of more
than one relative who resides with you so long as you submit a complete Form I-864A with evidence of assets for each
such relative.
Item Numbers 6. - 9. Assets of the Intending Immigrant. You may use the assets of the intending immigrant
regardless of where he or she resides. The intending immigrant must provide evidence of such assets with this affidavit.
Add together Item Numbers 6. - 8. and type or print the total number in Item Number 9. Form I-864A is not required to
document the intending immigrant’s assets.
Item Number 10. Total Value of Assets. In order to qualify based on the value of your assets, the total value of your
assets must equal at least five times the difference between your total household income and the current Federal Poverty
Guidelines for your household size. However, if you are a U.S. citizen and you are sponsoring your spouse or child age
18 years of age or older, the total value of your assets must only be equal to at least three times the difference. If the
intending immigrant is a foreign national orphan who will be adopted in the United States after he or she acquires legal
permanent residence, and who will, as a result, acquire citizenship under section 320 of the INA, the total value of your
assets need only equal the difference.
Example of How to Use Assets: If you are petitioning for a parent and the poverty line for your household size is
$22,062 and your current income is $18,062, the difference between your current income and the poverty line is $4,000.
In order for assets to help you qualify, the combination of your assets, plus the assets of any household member who is
signing Form I-864A, plus any available assets of the sponsored immigrant, would have to equal five times this difference
(5 x $4,000). In this case, you would meet the income requirements if the net value of the assets equaled at least $20,000.
Part 9. Sponsor’s Contract, Statement, Contact Information, Certification, and Signature
Form I-864 must be notarized by a notary public or by a foreign equivalent (as applicable), if the sponsor is outside the
United States. Read the contract carefully, then sign and date the affidavit before a notary public. If you do not sign and
date the affidavit, the intending immigrant you are sponsoring cannot be issued a visa or be granted adjustment of status.
Item Numbers 1.a. - 6.b. Select the appropriate box to indicate whether you read this affidavit yourself or whether you
had an interpreter assist you. If someone assisted you in completing the affidavit, select the box indicating that you used
a preparer. Further, you must sign and date your affidavit and provide your daytime telephone number, mobile telephone
number (if any), and email address (if any). Every affidavit MUST contain the signature of the sponsor (or parent or legal
guardian, if applicable). A stamped or typewritten name in place of a signature is not acceptable.

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Part 10. Interpreter’s Contact Information, Certification, and Signature
Item Numbers 1.a. - 7.b. If you used an interpreter to read the Instructions and questions on this affidavit to you in a
language in which you are fluent, the interpreter must fill out this section, provide his or her name, the name and address
of his or her business or organization (if any), his or her daytime telephone number, his or her mobile telephone number
(if any), and his or her email address (if any). The interpreter must sign and date the affidavit.
Part 11. Contact Information, Declaration, and Signature of the Person Preparing this Affidavit, if Other Than the
Sponsor
Item Numbers 1.a. - 8.b. This section must contain the signature of the person who completed your affidavit, if other
than you, the sponsor. If the same individual acted as your interpreter and your preparer, that person should complete
both Part 10. and Part 11. If the person who completed this affidavit is associated with a business or organization,
that person should complete the business or organization name and address information. Anyone who helped you
complete this affidavit MUST sign and date the affidavit. A stamped or typewritten name in place of a signature is not
acceptable. If the person who helped you prepare your affidavit is an attorney or accredited representative, and his or her
representation extends beyond preparation of this affidavit, he or she may also need to submit a completed Form G-28,
Notice of Entry of Appearance as Attorney or Accredited Representative or G-28I, Notice of Entry of Appearance as
Attorney In Matters Outside the Geographical Confines of the United States, along with your affidavit.

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Part 12. Additional Information

Item Numbers 1.a. - 7.d. If you need extra space to provide any additional information within this affidavit, use the
space provided in Part 12. Additional Information. If you need more space than what is provided in Part 12., you may
make copies of Part 12. to complete and file with your affidavit, or attach a separate sheet of paper. Type or print your
name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to
which your answer refers; and sign and date each sheet.
We recommend that you print or save a copy of your completed affidavit to review in the future and
for your records.

What Is the Filing Fee?

There is no filing fee to file Form I-864 with USCIS. For information on processing fees when filing with DOS, see
www.travel.state.gov.

Where To File?
Please see our website at www.uscis.gov/i-864 or visit the USCIS Contact Center at www.uscis.gov/contactcenter to
connect with a USCIS representative for the most current information about where to file this affidavit. The USCIS
Contact Center provides information in English and Spanish. For TTY (deaf or hard of hearing) call: 1-800-767-1833.
For information on filing with DOS, see www.travel.state.gov.
NOTE: If you are petitioning for a child who will be admitted to the United States based on an approved Form I-600,
Petition to Classify Orphan as an Immediate Relative, and will not acquire U.S. citizenship under section 320 of the INA,
you should file Form I-864 with the visa-issuing post at the Department of State, rather than with USCIS.

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Address Change
A sponsor must notify USCIS of his or her new address within 30 days of moving from his or her previous residence. To
do this, you must complete and file Form I-865, Sponsor’s Change of Address. For information on filing Form I-865, go
to the USCIS website at www.uscis.gov/I-865 or visit the USCIS Contact Center at www.uscis.gov/contactcenter for
help. The USCIS Contact Center provides information in English and Spanish. For TTY (deaf or hard of hearing) call:
1-800-767-1833. For information on reporting a change of address to the Department of State, see www.travel.state.gov.
NOTE: Do not complete Form I-865 at the same time that you complete Form I-864. You should complete and
submit Form I-865 to USCIS only when the address you indicated on the original Form I-864 has changed.

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This requirement does not relieve a lawful permanent resident sponsor from filing a change of address within 10 days of
the change. For information on filing a change of address go to the USCIS website at www.uscis.gov/addresschange
or visit the USCIS Contact Center at www.uscis.gov/contactcenter for help. The USCIS Contact Center provides
information in English and Spanish. For TTY (deaf or hard of hearing) call: 1-800-767-1833.
NOTE: Do not submit a change of address request to the USCIS Lockbox facilities because the Lockbox does not
process change of address requests.

Processing Information

Initial Processing. Once USCIS or DOS accepts your affidavit we will check it for completeness. If you do not
completely fill out this affidavit, you will not establish a basis for your eligibility and USCIS or DOS may reject or deny
your affidavit.
Requests for More Information. We may request that you provide more information or evidence to support your
affidavit. We may also request that you provide the originals of any copies you submit. If USCIS requests an original
document from you, it will be returned to you after USCIS determines it no longer needs your original.
Requests for Interview. We may request that you appear at a USCIS office for an interview based on your affidavit.
At the time of any interview or other appearance at a USCIS office, we may require that you provide your biometrics to
verify your identity and/or update background and security checks.

USCIS Forms and Information
To ensure you are using the latest version of this affidavit, visit the USCIS website at www.uscis.gov where you can
obtain the latest USCIS forms and immigration-related information. If you do not have internet access, you may order
USCIS forms by calling the USCIS Contact Center at 1-800-375-5283. The USCIS Contact Center provides information
in English and Spanish. For TTY (deaf or hard of hearing) call: 1-800-767-1833.
Instead of waiting in line for assistance at your local USCIS office, you can schedule an appointment online at
www.uscis.gov. Select “Tools,” then under “Self Service Tools,” select “Appointments” and follow the screen prompts to
set up your appointment. Once you finish scheduling an appointment, the system will generate an appointment notice for
you. If filing with DOS, see www.travel.state.gov.

Penalties
If you knowingly and willfully falsify or conceal a material fact or submit a false document with your Form I-864, we will
deny your Form I-864 and may deny any other immigration benefit. In addition, you will face severe penalties provided
by law and may be subject to criminal prosecution.
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The U.S. Government may pursue verification of any information provided on or in support of this affidavit, including
employment, income, or assets with the employer, financial or other institutions, the IRS, or the Social Security
Administration. If you include in this affidavit of support any information that you know to be false, you may be liable for
criminal prosecution under the laws of the United States.
If you fail to provide notice of your change of address, as required by 8 U.S.C. 1183a(d) and 8 CFR 213a.3, you may be
liable for the civil penalty established by 8 U.S.C. 1183a(d)(2). The amount of the civil penalty will depend on whether
you failed to provide this notice because you were aware that the immigrants you sponsored had received Federal, state, or
local means-tested public benefits.
If the failure to report your change of address occurs with knowledge that the sponsored immigrant received meanstested public benefits (other than benefits described in section 401(b), 403(c)(2), or 4ll(b) of the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996, which are summarized in Part 9. Sponsor’s Contract, Statement,
Contact Information, Declaration, Certification, and Signature of Form I-864) such failure may result in a fine of not
less than $2,000 or more than $5,000. Otherwise, the failure to report your change of address may result in a fine not less
than $250 or more than $2,000.

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DHS Privacy Notice

AUTHORITIES: The information requested on this affidavit, and the associated evidence, is collected under the
Immigration and Nationality Act sections 212(a)(4) and 213A.
PURPOSE: The primary purpose for providing the requested information on this affidavit is for you, the sponsor, to
demonstrate that you meet the eligibility requirements to execute this contract between a sponsor and the U.S. government
that imposes on the sponsor a legally enforceable obligation to support a sponsored alien until the obligation terminates.
An alien applicant who fails to submit a sufficient Affidavit of Support Under Section 213A of the INA, when statutorily
required, will be found inadmissible under INA section 212(a)(4). DHS uses the information you provide as part of
determining whether or not the adjustment of status applicant or the visa applicant you are sponsoring is eligible for the
immigration benefit.
DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information,
including your Social Security number (if applicable), and any requested evidence, may delay a decision on whether the
affidavit is found sufficient to meet the requirements of INA section 213A, and may result in the affidavit being found
insufficient.
ROUTINE USES: DHS may share the information you provide on this affidavit and any additional requested evidence
with other Federal, state, local, and foreign government agencies and authorized organizations. DHS follows approved
routine uses described in the associated published system of records notices [DHS/USCIS/ICE/CBP-001 Alien File, Index,
and National File Tracking System, DHS/USCIS-007 Benefits Information System and DHS/USCIS-018 Immigration
Biometric and Background Check (IBBC) System], and the published privacy impact assessments [DHS/USCIS/PIA016a Computer Linked Application Information Management System], which you can find at www.dhs.gov/privacy.
DHS may also share the information, as appropriate, for law enforcement purposes or in the interest of national security.

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Paperwork Reduction Act
An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection
of information, unless it displays a currently valid Office of Management and Budget (OMB) control number. The public
reporting burden for this collection of information is estimated at 7 hours per response, including the time for reviewing
instructions, gathering the required documentation and information, completing the affidavit, preparing statements,
attaching necessary documentation, and submitting the affidavit. Send comments regarding this burden estimate or any
other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Citizenship and
Immigration Services, Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave NW,
Washington, DC 20529-2140; OMB No. 1615-0075. Do not mail your completed Form I-864 to this address.

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