Declaration of Financial Support (e-File)

myUSCIS copy deck
I-134 Declaration of Finanical Support
OMB control number 1615-0014
Baseline version: 04/13/2022

Copy Deck Version

I-134:File a Form

File A Form Copy

Alerts
Link
We are only accepting online filing of Form
I-134 by individuals agreeing to financially
support Ukrainians who are filing parole
applications with U.S. Customs and Border
Protection (CBP).
At this time, we are only accepting online
filing of Form I-134 by individuals agreeing
to financially support Ukrainians filing
parole applicants with CBP. You must be
located in the United States in order to file
Form I-134 online. Ukrainians applying for
parole with CBP may not file Form I-134 on
their own behalf.

Some immigration benefits that involve a temporary stay in the United States require U.S. Citizenship and
Immigration Services (USCIS) to determine whether the applicant or beneficiary of the request has
sufficient financial resources or financial support to pay for expenses during the temporary stay. The
individual who signs and submits Form I-134 must establish that he or she has both sufficient financial
resources and access to those funds to support the beneficiary listed on Form I-134 for the duration of the
beneficiary’s stay in the United States.

If you are agreeing to financially support
any parolees from a country other than
Ukraine, or applicants for any other
immigration benefit, you must file a paper
Form I-134 through the appropriate
Lockbox location.

https://www.uscis.gov/i-134

File-A-Form

I-134:Overview

Heading
I-134, Declaration of
Finanical Support

Sub-Heading

Before You Start Your
Declaration

Eligibility

Body Text
Link
Some immigration benefits that involve a temporary stay in the United States require U.S. Citizenship and Immigration Services (USCIS) to determine whether the
applicant or beneficiary of the request has sufficient financial resources or financial support to pay for expenses during the temporary stay. The individual who signs
the submits Form I-134 must establish that he or she has both sufficient financial resources and access to those funds to support the beneficiary listed on Form I134 for the duration of the beneficiary’s stay in the United States.

Alerts

CTA

Notes
Form I-134 instructions,
page 1

Form I-134, Declaration of Financial Support, was previously titled “Form I-134, Affidavit of Support."
Certain individuals applying for parole based on urgent humanitarian reasons or significant public benefit filed on Form I 131, Application for Travel Document, must https://www.uscis.gov/i-864
submit this form with Form I-131. Form I-134 is filed either by the applicant for parole on his or her own behalf, or by another individual on the parole applicant’s
behalf.

We are only accepting online filing of Form I-134 by individuals
agreeing to financially support Ukrainians who are filing parole
applications with U.S. Customs and Border Protection (CBP).

Certain individuals applying for parole into the United States for urgent humanitarian reasons or significant public benefit who are not filing Form I-131 may also be
required to submit this form. In such cases, Form I-134 is completed by an individual other than the beneficiary who is agreeing to financially support the
beneficiary for the period of his or her temporary stay in the United States.

At this time, we are only accepting online filing of Form I-134 by
individuals agreeing to financially support Ukrainians filing parole
applicants with CBP. You must be located in the United States in
order to file Form I-134 online. Ukrainians applying for parole with
CBP may not file Form I-134 on their own behalf.

Note: Whether or not the beneficiary of this Form I-134 will have sufficient means of support while in the United States is an important factor in determining
whether to exercise discretion to authorize parole. We require evidence that the beneficiary of this Form I-134 has financial support for the duration of his or her
stay in the United States. Lack of evidence of financial support while in the United States is a strong negative factor that may lead to a denial of parole.
You may file this form on behalf of yourself or on behalf of a B, F, or M nonimmigrant requesting extension of stay or change of status.
Form I-134 may also be requested by Department of State in certain instances.

Form I-134 instructions,
page 1

If you are agreeing to financially support any parolees from a
country other than Ukraine, or applicants for any other
immigration benefit, you must file a paper Form I-134 through the
appropriate Lockbox location.

Do not use Form I-134 if the beneficiary you are agreeing to financially support must have Form I-864, Affidavit of Support Under Section 213A of the INA, filed on
his or her behalf instead.

Fee

There is no filing fee to file Form I-134.
Refund policy:
USCIS does not refund fees, regardless of any action we take on your application, petition, declaration, or request, or how long USCIS takes to reach a decision. By
continuing this transaction, you acknowledge that you must submit fees in the exact amount and that you are paying the fees for a government service.

Form I-134 instructions,
page 2

Please refer to the instructions for the form(s) you are filing for additional information or you may call the USCIS Contact Center at 800-375-5283. For TTY (deaf or
hard of hearing) 800-767-1833.

Documents you may need

You must be located in the United States in order to file Form I-134 on behalf of a Ukrainian parolee. Ukrainians requesting parole may not file Form I-134 on their
own behalf.

Need to clarify what to say
in this section.

As the person who agrees to financially support the beneficiary, you must show you have sufficient income or finanical resources to support the beneficiary.
Evidence should consist of copies of any of the documents listed below that apply.
Failure to provide evidence of sufficent income or financial resources may result in the denial of the foreign national's application for a visa or his or her removal
from the United States.
Submit in duplicate evidence of income and resources, appropriate:

Form I-134 instructions

1. Statement from an officer of the bank or other financial institutions with deposits, identifying the following details regarding the account:
- Date account opened
- Total amount deposited for the past year; and
- Present balance.
2. Statement(s) form your employer on business stationery showing:
- Date and nature of employment;
- Salary paid; and
- Whether the position is temporary or permanent
3. Copy of last U.S. federal income tax return filed (tax transcript); or
4. List containing serial numbers and denominations of bonds and name of record owner(s).
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 or petition. After USCIS receives your declaration 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 you 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.

Specific to digital
environment and part of
global template previously
approved by OMB

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

Completing Your Form
Online

Track your case online

After you submit your form, you can track its status through your USCIS account. Sign in to your account often to check your case status and read any important
messages from USCIS.

Respond to requests for information

If we need more information from you, we will send you a Request for Evidence (RFE) or Request for Information (RFI). You can respond to our request and upload
your documents through your USCIS account.

Receive your decision

The decision on the Form I-134 involves a determination of whether you have established a basis of support for the beneficary seeking an immigration benefit.
USCIS will notify you of the decision in writing.

Filing online

Submitting your declaration online is the same as mailing in a completed paper form. They both gather the same information.

Complete the Getting Started section first

You should answer all questions in the Getting Started section first so we can best customize the rest of your online form experience.

Specific to digital
environment and part of
global template previously
Specific to digital
environment and part of
global template previously

Specific to digital
environment and part of
global template previously
approved by OMB
Specific to digital
environment and part of
global template previously
approved by OMB

Overview

I-134:Overview

Heading

Sub-Heading
Provide as many responses as you can

Body Text
You should provide as many responses as you can. Incomplete fields or sections and missing information can slow down the process after you submit your form.

We will automatically save your responses

We will automatically save your information when you select next to go to a new page or navigate to another section of the form. We will save your information for
30 days from today, or from the last time you worked on the form.

How to continue filling out your form

After you start your form, you can sign in to your account to continue your form.

DHS Privacy Notice

AUTHORITIES: The information requested on this declaration, and the associated evidence, is collected under the Immigration and Nationality Act sections 212(d)(5),
214 and 248.

Form I-134 instructions pg 78

PURPOSE: The primary purpose for providing the requested information on this declaration of financial support is to determine whether the beneficiary of this
declaration has adequate financial means to support themselves and that, if this individual is admitted or paroled into the United States, this individual has sufficient
financial resources available to them for the duration of their temporary stay in the United States. DHS uses the information you provide to grant or deny the
immigration benefit the beneficiary of Form I-134 is seeking.

Form I-134 instructions pg 78

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 final decision or result in denial of the beneficiary’s benefit request.

Form I-134 instructions pg 78

ROUTINE USES: DHS may share the information you provide on this declaration 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] and the published privacy impact assessments [DHS/USCIS/PIA-003 Integrated Digitization Document Management Program
(IDDMP), DHS/USCIS/PIA-056 USCIS Electronic Immigration System, DHS/USCIS/PIA-071 myUSCIS Account Experience, and DHS/USCIS/PIA-051 Case and Activity
Management for International Operations] which you can find at www.dhs.gov/privacy. DHS may also share this information, as appropriate, for law enforcement
purposes or in the interest of national security.

Form I-134 instructions pg 78

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 1.83 hours per
response, including the time for reviewing instructions, gathering the required documentation and information, completing the declaration, preparing statements,
attaching necessary documentation, and submitting the declaration. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to:

Form I-134 instructions pg 78

Paperwork Reduction Act

Link

Alerts

CTA

Notes
Specific to digital
environment and part of
global template previously
approved by OMB
Specific to digital
environment and part of
global template previously
approved by OMB
Specific to digital
environment and part of
global template previously
approved by OMB

U.S. Citizenship and Immigration Services
Office of Policy and Strategy, Regulatory Coordination Division
5900 Capital Gateway Drive, Mail Stop #2140
Camp Springs, MD 20588-0009
Do not mail your completed Form I-134 to this address.
OMB No. 1615-0014
Expires: XX/XX/XXXX

Security reminder

If you do not work on your declaration for more than 30 days, we will delete your data in order to prevent storing personal information indefinitely.

Start

Specific to digital
environment and part of
global template previously
approved by OMB

Overview

I-134: GETTING STARTED

Primary Nav
Getting Started

Secondary Nav
Basis for filing

Tertiary Nav

Paper Form Question
1.1.

Question
Sub-Question
Field Type
On whose behalf are you
Another individual who is the beneficiary Radio
filing this form?
Is someone assisting you with Yes/No
Radio
completing this declaration?

Instructional Text

(IF YES) Is a preparer assisting Yes/No
you with completing this
declaration?

Radio

A preparer is anyone who
completes or helps you complete
all or part of your declaration
using information and answers
that you provide.

(IF YES) Is an interpreter
Yes/No
assisting you with completing
this declaration?

Radio

An interpreter is anyone who
translates or helps you translate
all or part of your declaration
using information and answers
that you provide.

7.1

What is your preparer's full
name?

Given name (first name)

Text

7.2

What is your preparer's
business or organization
name?

Family name (last name)

Text
Text

My preparer is not part of a business or
organization.
Country

Checkbox

Address line 1
Address line 2
City or town
State/Province
ZIP code/Postal code
Daytime phone number

Text
Text
Text
Dropdown/Text
Text
Text

Preparer and
interpreter
information

(IF YES TO
PREPARER
QUESTION)
Preparer
information

7.3

7.4
7.5

7.6

(IF YES TO
INTERPRETER)
Interpreter
information

6.1

6.2

6.3

What is your preparer's
mailing address?

What is your preparer's
contact information?

Mobile telephone number
My preparer does not have a mobile
telephone number
Email address
My preparer does not have an email
address.
What is your interpreter's full Given name (first name)
name?

What is your interpreter's
business or organization
name?

What is your interpreter's
mailing address?

Family name (last name)

Help Text

Notes
[FOR MVP],this will be the
only option available
Specific to digital environment
and part of global template
previously approved by OMB.
Specific to digital environment
and part of global template
previously approved by OMB.

Specific to digital environment
and part of global template
previously approved by OMB.

Dropdown
Street number and name
Apartment, suite, unit, or floor

Text
Checkbox
Text
Checkbox
Text

Text
Text

My interpreter is not part of a business or Checkbox
organization.
Country
Dropdown
Address line 1
Address line 2
City or town
State/Province

Text
Text
Text
Dropdown/Text

Street number and name
Apartment, suite, unit, or floor

Getting Started

I-134: GETTING STARTED

Primary Nav

Secondary Nav

Tertiary Nav

Paper Form Question

Question

6.4

What is your interpreter's
contact information?

6.5

6.6

(IF YES TO
INTERPRETER)
Interpreter
information

Sub-Question
ZIP code/Postal code
Daytime telephone number

Field Type
Text
Text

Mobile telephone number
My interpreter does not have a mobile
telephone number
Email address
My interpreter does not have an email
address.

Text
Checkbox

Text

Family name (last name)

Text
Text

What is your interpreter's
mailing address?

What is your interpreter's
contact information?

What language is your
interpreter using to interpret
this declaration for you?

Help Text

Notes

Text
Checkbox

What language is your
interpreter using to interpret
this delcaration for you?
What is your interpreter's full Given name (first name)
name?

What is your interpreter's
business or organization
name?

Instructional Text

Text

My interpreter is not part of a business or Checkbox
organization.
Country
Dropdown
Address line 1
Address line 2
City or town
State/Province
ZIP code/Postal code
Daytime telephone number

Text
Text
Text
Dropdown/Text
Text
Text

Mobile telephone number
My interpreter does not have a mobile
telephone number
Email address
My interpreter does not have an email
address.

Text
Checkbox

Street number and name
Apartment, suite, unit, or floor

Text
Checkbox
Text

Getting Started

I-134: About the Individual Agreeing to Financially Support the Beneficiary

Primary Nav
About the Individual
Agreeing to Financially
Support the Beneficiary

Secondary Nav
Tertiary Nav
Name of the
individual agreeing
to financially
support the
beneficiary

Paper Form Question
3.1.

3.1.
3.1.
3.2

Question
What is your current legal
name?

Have you used any other
names since birth?

[If yes to 3.2]

Sub-Question
Given name (first name)

Field Type
Text

Middle name
Family name (last name)
Yes/No

Text
Text

Alert

Help Text
Instructional Text
Your current legal name is the
name on your birth certificate,
unless it changed after birth by a
legal action such as marriage or
court order. Do not provide any
nicknames here.

Notes

Other names used may include
nicknames, aliases, and
maiden names.

Given name (first name)

Provide the other names you
have used.

Middle name
Family name (last name)
Contact
information for the
individual agreeing
to financially
support the
beneficiary

5.3

How may we contact you?

5.4

5.5
3.3

What is your current mailing
address?

3.3
3.3
3.3
3.3
3.3
3.3

When and Where
the individual
agreeing to
financially support
the beneficiary was
born

Daytime telephone number

Text (9 digits)

Mobile telephone number (if any)
This is the same as my daytime telephone
number.
Email address
In care of name (if any)

Text (9 digits)
Checkbox

Country
Address line 1
Address line 2
City or town
State/Province or region (FOR FOREIGN
ADDRESS)
ZIP code/Postal code (FOR FOREIGN
ADDRESS)
Yes/No

Dropdown

Text
Text

3.4

Is your mailing address the
same as the physical
address?

3.5

[If NO] What is your physical
address?

Address line 1

Text

Address line 2
City or town
State
ZIP code

Text
Text
Dropdown
Text

3.6

What is your date of birth?

(mm/dd/yyyy)

Date

3.7

What is your city, town, or
village of birth?
What is your state or
province of birth?

3.7

Radio

You must be located
in the United States
in order to file at
this time.

You must be located
in the United States
in order to file at
this time.

Required field

Text
Text

About the IATFSB

I-134: About the Individual Agreeing to Financially Support the Beneficiary

Primary Nav

Secondary Nav

Immigration
information for the
individual agreeing
to financially
support the
beneficiary

Tertiary Nav

Paper Form Question
3.7

Question
What is your country of
birth?

Sub-Question

Field Type
Dropdown

3,10

What is your current
immigration status?

U.S. Citizen

Radio

U.S. National
Lawful Permanent Resident
Nonimmigrant
Other
A-

Radio
Radio
Radio
Radio
Text (9 digits)

3,10
3,10
3,10
3,10
3.8

3.9

What is your A-number?

I do not have or know my ANumber.
What is your USCIS Online
Account Number?

Alert

Instructional Text

Notes

A-Number is required if Lawful
Permanent Resident is selected.

Checkbox
Text (12 digits)

Help Text

You will only have an OAN if you
previously filed a form that has a
receipt number that begins with
IOE. If you filed the form online,
you can find your OAN in your
account profile. If you mailed us
the form, you can find your OAN
at the top of the Account Access
Notice we sent you.
If you do not have receipt
number that begins with IOE, you
do not have an OAN.

I do not have or know my
USCIS Online Account
Number.
What is your relationship to
the beneficiary?
What is your Form I-94 ArrivalDeparture Record Number?

Checkbox

[If Other]

Please provide an
explanation.

Textbox

3.11

What is your employment
status?

[If Nonimmigrant]

Employment
information for the
individual agreeing
to financially
support the
beneficiary

[If Other]
[If EMPLOYED to 3.11]
3.12A
[If EMPLOYED to 3.11]
3.12B
[IF 3.12A]
[IF 3.12A]
[IF 3.12B]
3.13

Please provide an
explanation.
I am currently employed as
a/an
I am currently self-employed
as a/an
Name of employer

What is your current
employer's address?

(The OAN is not the same as an ANumber.)

Textbox

Employed (full-time, part-time, seasonal, Dropdown
self-employed)
Unemployed or not employed
Retired
Other

Textbox
Radio
Radio

Country

Text
Text
Text
Dropdown

Address line 1
Address line 2
City or town
State/Province or region (FOR FOREIGN
ADDRESS)
ZIP code/Postal code (FOR FOREIGN
ADDRESS)

About the IATFSB

I-134: Financial Information About the Person Agreeing to Financially Support the Beneficiary

Primary Nav
Financial Information
About the Individual
Agreeing to Financially
Support the Beneficiary

Secondary Nav
Tertiary Nav
Income
information for the
individual agreeing
to financially
support the
beneficiary

Paper Form Question

Question

Sub-Question

Add entry
3.14 [LARGE TABLE]

What is the individual's
current legal name?

Field Type

CTA

Instructional Text
Provide all of the information requested in the table
below about yourself, all of your dependents, and any
other individuals you financially support. Do not include
any individuals listed in the "Beneficiary's Financial
Information" section.

Help Text

Notes

Information about assets that are not based on
employment should be added in the "Assets of the
individual agreeing to financially support the beneficiary"
section below.

Given name (first name)

Middle name

Family name (last name)
What is the individual's date (mm/dd/yyyy)
of birth?
What is the individual's
relationship to the individual
agreeing to financially
support the beneficiary?
How much income will this
individual contribute to the
beneficiary annually?
Save Entry
Cancel
3.14
3.14

Additional income
information for the
individual agreeing
to financially
support the
beneficiary

What is the total number of
dependents?
What is the total income?

$

Date
Text

If you are the individual agreeing to financially support the
beneficiary, type in "Self".

Text (numerical)

If the income contribution is none, type in "0".

CTA
CTA
Text
$

Text (numerical)

3.15

Does any of the income listed Yes/No
come from an illegal activity
or source (such as proceeds
from illegal gambling or
illegal drug sales)?

Radio

[If YES to 3.15] 3.16

What amount of income
$
comes from an illegal
activity?
Does any of the income listed Yes/No
above come from meanstested public benefits as
defined in 8 CFR 213a.1?

Text (numerical)

3.21

What amount of income is
from means-tested public
benefits?
Do you intend to make
specific contributions to the
support of the beneficiary
named in this Form I-134?

A means-tested benefit is a public benefit—offered by
federal, state, or local agencies—for which eligibility and
amount considerations are based on a person’s income
and resources. USCIS formerly considered Medicaid,
Supplemental Nutrition Assistance Program, Temporary
Assistance to Needy Families, and Supplemental Security
Income during eligibility evaluations

$

Yes/No

Radio

IATFSB Finanical Info

I-134: Financial Information About the Person Agreeing to Financially Support the Beneficiary

Primary Nav

Secondary Nav

Tertiary Nav

Paper Form Question
[If YES to 3.12]

Question
Sub-Question
Explain the contribution. For
example, if you intend to
furnish room and board,
state for how long. If you
intend to provide money,
state the amount in U.S.
dollars and whether it is to
be given in a lump sum,
weekly, or monthly, and for
how long.

Field Type
Text box

Assets of the
individual agreeing
to financially
support the
beneficiary

Instructional Text

Help Text

Notes

Provide information about any assets you will use to
support the beneficiary for the anticipated period of his or
her stay. List only assets that can be converted into cash
within 12 months and that will be used to support the
beneficiary while the beneficiary is in the United States.
Provide the value of all assets listed in the U.S. dollars,
regardless of whether they are held in the United States
or outside of the United States. Do not include assets from
any individuals in the “Beneficiary’s Financial Information”
section.

3.17 [LARGE TABLE]

Add entry
What is the asset holder's
current legal name?

Given name (first name)

Middle name
Family name (last name)
N/A
Checking - Bank Account
Savings - Bank Account
Annuities
Stockes, Bonds, Certificates of Deposit
Retirement or Educational Account
Real Estate Holdings
Personal Property (not value)
What is the cash value in U.S. $
dollars?
Save Entry
Cancel
What is the type of asset?

What is the total amount
(U.S. dollars)?
3.18

[If YES to 3.18, conditional
"Sponsor financial
responsibility" page
displays]

$

Have you previously
Yes/No
submitted a Form I-134 on
behalf of a person other than
the beneficiary listed on this
Form I-134?

CTA

You may also include your household members’ assets
below. Attach evidence in the "Evidence" section under
"Proof of Assets and Bonds" showing that you, or your
dependents, have these assets.

Dropdown

Text (numerical)
CTA
CTA

Text (numerical)
Radio

IATFSB Finanical Info

I-134: Financial responsibility for other beneficiaries

Primary Nav
Financial responsibility
for other beneficiaries

Secondary Nav
Tertiary Nav
Financial
responsibility for
other beneficiaries

Paper Form Question

3.19 [LARGE TABLE]

Question

Sub-Question

Field Type

Add entry

CTA

What is the person's current Given name (first name)
legal name?
Middle name

Text

Family name (last name)
A-

Text
Text

What is the person's Anumber?
I do not have or know the
person's A-Number.
Date submitted

Instructional Text
Provide the information about
the persons who you have
previously submitted a Form I134 other than the beneficiary
listed on this Form I-134.

Help Text

Notes

[If YES to 3.18]

Text

Checkbox
(mm/dd/yyyy)

Date

IATFSB financial responsiblity

I-134: About the Beneficiary

Primary Nav
About the Beneficiary

Secondary Nav
Beneficiary name

Tertiary Nav

Paper Form Question
2.1.

Question
What is the beneficiary's
current legal name?

2.1.
2.1.
2.2

Middle name
Family name (last name)
Has the beneficiary used any Yes/No
other names since birth?

[If yes to 2.2]

Sub-Question
Given name (first name)

Field Type
Text

Text
Text

Given name (first name)

Alerts

Instructional Text
Help Text
The beneficiary's current legal
name is the name on their birth
certificate, unless it changed
after birth by a legal action such
as marriage or court order. Do
not provide any nicknames here.

Notes

Other names used may
include nicknames, aliases,
and maiden names.

Provide the other names the
beneficiary has used.

Middle name
Family name (last name)
Beneficiary contact
information

4.3

How may we contact the
beneficiary?

4.4

4.5
2.9
2.9
2.9
2.9
2.9
2.9

What is the beneficiary's
current mailing address?

2.9
2,10

2.11

2.11
2.11
2.11
2.11

Is the beneficiary's mailing
address the same as the
physical address?
(If no) What is the
beneficiary's physical
address?

2.11

When and where
beneficiary was
born

Daytime telephone number

Text (9 digits)

Mobile telephone number (if any)
This is the same as my daytime
telephone number.
Email address
In care of name (if any)

Text (9 digits)
Checkbox

Country
Address line 1
Address line 2
City or town
State/Province or region (FOR FOREIGN
ADDRESS)
ZIP code/Postal code (FOR FOREIGN
ADDRESS)
Yes/No

Dropdown

Country

Dropdown

Text
Text

Radio

Address line 1
Address line 2
City or town
State/Province or region (FOR FOREIGN
ADDRESS)
ZIP code/Postal code (FOR FOREIGN
ADDRESS)

2.3

What is the beneficiary's date (mm/dd/yyyy)
of birth?

Date

2.6

What is the beneficiary's city
or town of birth?
What is the beneficiary's
state or province of birth?
What is the beneficiary's
country of birth?

Text

2.6
2.6

Required field

Text
Dropdown

About the Beneficiary

I-134: About the Beneficiary

Primary Nav

Secondary Nav
Other information
about the
beneficiary

Tertiary Nav

Paper Form Question
2.4

Question
What is the beneficiary's
gender?

2.8

What is the beneficiary's
martial status?

2.8
2.8
2.8
2.8
2.8
2.8
2.8
2.7

2.5

2.12

[If OTHER]
What is the beneficiary's
country of citizenship or
nationality?

What is the number of the
beneficiary's most recently
issued passport?
What country issued the
beneficiary's most recently
issued passport?
What is the expiration date
of the beneficiary's most
recently issued passport?
What is the beneficiary's ANumber?
I do not have or know the
beneficiary's A-Number.
What is the beneficiary's
anticipated period of stay in
the United States?

Sub-Question
Male

Field Type
Radio

Female
Single, Never Married

Radio
Radio

Married
Divorced
Widowed
Legally Separated
Marriage Annulled
Other
Provide an explanation

Radio
Radio
Radio
Radio
Radio
Radio
Text box
Dropdown

Text

Alerts

At this time, we are only
accepting online filing of
Form I-134 by individuals
agreeing to financially
support Ukrainians filing
parole applicants with CBP.

Instructional Text

Help Text

Notes

Only Ukraine will be available in
dropdown

Dropdown

Date

A-

Text (9 digits)

From (mm/dd/yyyy)

Date

To (mm/dd/yyyy)
No End Date

Date
Checkbox

Checkbox

About the Beneficiary

I-134: Beneficiary's Financial Information

Primary Nav
Beneficiary's Financial
Information

Secondary Nav
Paper Form Question
Beneficiary income
information

Question

Sub-Question

Add entry

2.13 [LARGE TABLE]

What is the individual's
current legal name?

Field Type

Instructional Text
Help Text
Provide information about the income
and assets about the beneficiary, all of the
beneficiary's dependents, and any other
individuals the beneficiary financially
supports. Do not include any individuals
named in the "Financial Information
About the Individual Agreeing to
Financially Support the Beneficiary"
section.

CTA

Notes

Opens up large table once
clicked

Provide all of the information requested
in the table below about the beneficiary,
all of the beneficiary’s dependents, and
any other individuals the beneficiary
financially supports (do not include
information about the sponsor, even if
you are sponoring yourself). Information
about assets that are not based on
employment should not be included here
but may be added under "Beneficiary
Assets" below.

Given name (first name)
Middle name

Family name (last name)

What is individual's date of
birth?
What is the individual's
relationship to the
beneficiary?
How much income will this
individual contribute to the
beneficiary annually?

(mm/dd/yyyy)

Date
Text

$

Text (numerical)

Save Entry
Cancel

CTA
CTA

2.13

What is the beneficiary's total
number of dependents?

Text

2.13

How much income will the
$
beneficiary's dependents
contribute to the beneficiary
annually?

Text (numerical)

If the income contribution is none, type in
"0".

Beneficiary's Financial Info

I-134: Beneficiary's Financial Information

Primary Nav

Secondary Nav
Beneficiary
additional income
information

Paper Form Question
2.14

[If YES to 2.14] 2.15

X.xx

[If YES to ^]

Question
Does any of the beneficiary's
total income (including
income from dependents and
other individuals who
contribute to the
beneficiary's income,
excluding any individuals
named in the "Financial
Information About the Person
Agreeing to Financially
Support the Beneficiary"
section)
come from an illegal activity
or source (such as proceeds
from illegal gambling or illegal
drug sales)?
What amount of the
beneficiary's total income
comes from an illegal activity
or source?
Does any of the income listed
above come from meanstested public benefits as
defined in 8 CFR 213a.1?

Sub-Question
Yes/No

Field Type
Radio

$

Text (numerical)

What amount of income is
from means-tested public
benefits?

$

Instructional Text

Help Text

Notes

Yes/No

Beneficiary assests

Provide the current cash vaue of assets
available to the beneficiary for the
expected period of his or her stay
(excluding assets from any individuals
named in the "Financial Information
About the Individual Agreeing to
Financially Support the Beneficiary"
section).
You may also include assets owned by the
beneficiary's dependents.

2.16 [LARGE TABLE]

Add entry
What is the asset holder's
current legal name?

Given name (first name)

Middle name
Family name (last name)
What is the type of asset?
N/A
Checking - Bank Account
Savings - Bank Account
Annuities
Stockes, Bonds, Certificates of Deposit
Retirement or Educational Account
Real Estate Holdings
Personal Property (not value)
What is the cash value of the $
asset in U.S dollars?
Save Entry
Cancel

CTA

Attach evidence in the "Evidence" section
under "Proof of Assets and Bonds"
showing that the beneficiary has these
assets.

Dropdown

Text (numerical)
CTA
CTA

Beneficiary's Financial Info

I-134: Beneficiary's Financial Information

Primary Nav

Secondary Nav

Paper Form Question

Question

Sub-Question

What is the total amount
(U.S. dollars)?

$

Field Type

Instructional Text

Help Text

Notes

Text (numerical)

Beneficiary's Financial Info

I-134: Evidence

Primary Nav

Secondary Nav

Evidence

Bank officer
statement

Tertiary Nav

Paper Form Question

Instructional Text

Form I-134 instructions (pg Provide a statement from an officer of the bank or other financial institutions with deposits, identifying the
5)
following details:

Field Type

File Requirements

Upload

• Clear and readable
• Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
• No encrypted or password-protected files
• If your documents are in a foreign language, upload a
full English translation and the translator’s certification
with each original document
• Upload no more than five documents at a time
• Accepted file name characters: English letters,
numbers, spaces, periods, hyphens, underscores, and
parentheses
• Maximum size: 6MB per file
• Clear and readable
• Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
• No encrypted or password-protected files
• If your documents are in a foreign language, upload a
full English translation and the translator’s certification
with each original document
• Upload no more than five documents at a time
• Accepted file name characters: English letters,
numbers, spaces, periods, hyphens, underscores, and
parentheses
• Maximum size: 6MB per file
• Clear and readable
• Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
• No encrypted or password-protected files
• If your documents are in a foreign language, upload a
full English translation and the translator’s certification
with each original document
• Upload no more than five documents at a time
• Accepted file name characters: English letters,
numbers, spaces, periods, hyphens, underscores, and
parentheses
• Maximum size: 6MB per file

- Date account opened
- Totatl amount deposited for the past year; and
- Present balance.

Employer
statement

As the beneficiary or the person who agrees to financially support the beneficiary, you must show you have
sufficent income or finanacial resources to support the beneficiary. Failure to provide evidence of sufficent
income or financial resources may result in the denial of the foriegn national's application for a visa or his or
her removal from the United States.
Form I-134 instructions (pg Provide statement(s) from your employer on business stationery showing:
Upload
5)
- Date and nature of employment
- Salary paid; and
- Whether the position is temporary or permanent.
As the beneficiary or the person who agrees to financially support the beneficiary, you must show you have
sufficent income or finanacial resources to support the beneficiary. Failure to provide evidence of sufficent
income or financial resources may result in the denial of the foriegn national's application for a visa or his or
her removal from the United States.

Income tax return

Bonds

Proof of
immigration status

Form I-134 instructions (pg Provide a copy of the last U.S. federal income tax return filed (tax transcript).
Upload
6)
As the beneficiary or the person who agrees to financially support the beneficiary, you must show you have
sufficent income or finanacial resources to support the beneficiary. Failure to provide evidence of sufficent
income or financial resources may result in the denial of the foriegn national's application for a visa or his or
her removal from the United States.

Document types
dropdown
Bank officer
statement

Notes

Employer
statement
Other documents

Income tax return
Other documents

• Clear and readable
• Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
• No encrypted or password-protected files
• If your documents are in a foreign language, upload a
full English translation and the translator’s certification
with each original document
• Upload no more than five documents at a time
• Accepted file name characters: English letters,
numbers, spaces, periods, hyphens, underscores, and
parentheses
• Maximum size: 6MB per file

Bonds

Form I-134 instructions (pg Provide evidence of your status.
Upload
5 Item #10: Immigration
Status)
A U.S. citizen or U.S. national may submit a copy of a birth certificate, certificate of naturalization, certificate
of citizenship, consular report of birth abroad to U.S. parents, or a copy of the biographic data page on your
U.S. passport.

• Clear and readable
• Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
• No encrypted or password-protected files
• If your documents are in a foreign language, upload a
full English translation and the translator’s certification
with each original document
• Upload no more than five documents at a time
• Accepted file name characters: English letters,
numbers, spaces, periods, hyphens, underscores, and
parentheses
• Maximum size: 6MB per file

Immigration status

Proof of lawful nonimmigrant status may include a copy of an unexpired visa in a foriegn passport.

Help Text

Other documents

Form I-134 instructions (pg Provide a list containing serial numbers and denominations of bonds and name of record owner(s).
Upload
6)
As the beneficiary or the person who agrees to financially support the beneficiary, you must show you have
sufficent income or finanacial resources to support the beneficiary. Failure to provide evidence of sufficent
income or financial resources may result in the denial of the foriegn national's application for a visa or his or
her removal from the United States.

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 From I-94 Arrival Departure Record.

Logic

Other documents

Other documents

Evidence

I-134: Evidence

Primary Nav

Secondary Nav

Evidence

Proof of assets of
individual agreeing
to financially
support the
beneficiary

Tertiary Nav

Paper Form Question

Instructional Text

Field Type

Form I-134 instructions (pg Provide information about any assets you will use to support the beneficiary for the anticipated period of
Upload
5 Item #17: Assets
his or her stay. List only assets that can be converted into cash within 12 months and that will be used to
support the beneficiary while the beneficiary is in the United States. Provide the value of all assets listed in
the U.S. dollars, regardless of whether they are held in the United States or outside of the United States. Do
not include assets from any individuals in the “Beneficiary’s Financial Information” section.
You may include the net value of a home as an asset. The net value of the home is the appraised value of
the home, minus the sum of all loans secured by a mortgage, trust deed, or other lien on the home. If you
include the net value of your home, then you must include documentation demonstrating that you own the
home, a recent appraisal by a licensed appraiser, and evidence of the amount of all loans secured by a
mortgage, trust deed, or other lien on the home.

File Requirements
• Clear and readable
• Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
• No encrypted or password-protected files
• If your documents are in a foreign language, upload a
full English translation and the translator’s certification
with each original document
• Upload no more than five documents at a time
• Accepted file name characters: English letters,
numbers, spaces, periods, hyphens, underscores, and
parentheses
• Maximum size: 6MB per file

Document types
dropdown
Assets

Logic

Help Text

Notes

Other documents"

You may not include the net value of an automobile unless you show that you have more than one
automobile, and at least one automobile is not included as an asset.
Submit evidence of the value of your or your household members’ assets. Evidence must include the name
of the asset holder, a description of the asset, proof of ownership, and the basis for the owner’s claim of its
net cash value.
As the beneficiary or the person who agrees to financially support the beneficiary, you must show you have
sufficent income or finanacial resources to support the beneficiary. Failure to provide evidence of sufficent
income or financial resources may result in the denial of the foriegn national's application for a visa or his or
her removal from the United States.
Proof of
beneficiary's assets

Form I-134 instructions (pg Provide information about any assets available to the beneficiary for the anticipated period of his or her
4 Item #16: Beneficiary's
stay. List only assets that can be converted into cash within 12 months and that will be used to support he
Assets
beneficiary while the beneficiary is in the United States. Provide the value of all assets listed in the U.S.
dollars, regardless of whether the assets are held in the United States or outside the United States. Do not
include assets from any individuals in the "Financial Information About the Person Agreeing to Financially
Support the Beneficiary" section.
You may include the net value of the beneficiary’s home as an asset. The net value of the home is the
appraised value of the home, minus the sum of all loans secured by a mortgage, trust deed, or other lien on
the home. If you list the net value of the beneficiary’s home, then you must include documentation
demonstration that the beneficiary owns the home, a recent appraisal by a licensed appraiser, and evidence
of the amount of all loans secured by a mortgage, trust deed, or other lien on the home.

Upload

• Clear and readable
• Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
• No encrypted or password-protected files
• If your documents are in a foreign language, upload a
full English translation and the translator’s certification
with each original document
• Upload no more than five documents at a time
• Accepted file name characters: English letters,
numbers, spaces, periods, hyphens, underscores, and
parentheses
• Maximum size: 6MB per file

Beneficiary asset
Other documents

You may not include the net value of the beneficiary’s automobile unless the beneficiary has more than one
automobile, and at least one automobile is not include as an asset. Submit evidence of the value of the
assets listed. Evidence must include the name of the asset holder, a description of the asset, proof of
ownership, and the basis of the owner’s claim of its net cash a value.
You may submit evidence of the value of the beneficiary's household members’ assets. Evidence must
include the name of the asset holder, a description of the asset, proof of ownership, and the basis for the
owner’s claim of its net cash value.
As the beneficiary or the person who agrees to financially support the beneficiary, you must show you have
sufficent income or finanacial resources to support the beneficiary. Failure to provide evidence of sufficent
income or financial resources may result in the denial of the foriegn national's application for a visa or his or
her removal from the United States.

Evidence

I-134: Additional Information

Primary Nav
Secondary Nav
Additional Information Additional
information

Tertiary Nav

Paper Form Question
Part 8

Question
You may provide additional
information for your
declaration.

Sub-Question
Additional information

Field Type
No

Instructional Text
Help Text
If you need to provide any
additional information for any of
your answers to the questions in
this form, enter it into the space
below. You should include the
questions that you are
referencing.

Notes

If you do not need to provide any
additional information, you may
leave this section blank.

Additional Information

I-134: Review and Submit

Primary Nav

Review and Submit

Secondary Nav
Review your declaration

Tertiary Nav

Paper Form

Question
Check your declaration before you submit

Sub-Question

Field Type

Instructional Text
Help Text
We will review your declaration to check for accuracy and completeness before you
submit it.

CTA

Notes
Specific to digital environment and part of
global template previously approved by OMB.

We encourage you to provide as many responses as you can throughout the
declaration, to the best of your knowledge. Missing information can slow down the
review process after you submit your declaration.
You can return to this page to review your declaration as many times as you want
before you submit it.
Alerts and warnings

You have one or more alerts and warnings based on the information you provided in your
declaration.

Specific to digital environment and part of
global template previously approved by OMB.

A red alert means you have incomplete responses or inconsistent data. You cannot submit
your declaration with any alerts.

Your declaration summary

Here is a summary of all the information you provided in your declaration.

Review the I-134 form information

Make sure you have provided responses for everything that applies to you before
you submit your declaration. You can edit your responses by going to each
declaration section using the site navigation.

Next

Specific to digital environment and part of
global template previously approved by OMB.

We also prepared a draft case snapshot with your responses, which you can
download below.

(IF PREPARER) Preparer
statement

7.7

Preparer's statement

I am not an attorney or accredited representative but have prepared this declaration on behalf of the individual agreeing to financially support the beneficiary
(which is the beneficiary if filling on behalf of him or herself) and with that individual's consent

Radio

Your preparer must read the statements below and select the statement that applies to him
or her.

Will remove (which is the beneficiary if filling
on behalf of him or herself) for MVP

If your preparer is an attorney or accredited representative whose representation extends
beyond preparation of this declaration, he or she may be obliged to submit a completed
Notice of Entry of Appearance as Attorney or Accredited Representative (G-28) with your
declaration.

Preparer's certification and signature

I am an attorney or accredited representative and my representation of the individual agreeing to financially support the beneficiary (which is the beneficiary if Radio
filling on behalf of him or herself) in this case does not extend beyond the preparation of this declaration.
I am an attorney or accredited representative and my representation of the individual agreeing to financially support the beneficiary (which is the beneficiary if Radio
filling on behalf of him or herself) in this case extends beyond the preparation of this declaration.
By my signature, I certify, under penalty of perjury, that I prepared this declaration at the request of the individual agreeing to financially support the
beneficiary (which is the beneficiary if filling on behalf of him or herself). The individual agreeing to financially support the beneficiary (which is the beneficiary
if filling on behalf of him or herself) then reviewed this completed declaration and informed me that he or she understands all of the information contained in,
and submitted with, his or her declaration, including the Certification of the Individual Agree to Financially Support the Beneficiary, and that all of this
information is complete, true, and correct. I completed this declaration based only on information that the individual agreeing to financially support the
beneficiary provided to me or authorized me to obtain or use.

Your preparer must read and agree to the certification below.

As the applicant's preparer, you must sign on paper and provide your signature page to the applicant. Follow these steps:

Specific to digital environment and part of
global template previously approved by OMB.

1. Download the Preparer Signature page
2. Print the Preparer Signature page
3. Read and sign the Preparer Signature page
4. Give the signed Preparer Signature page to the applicant
(IF PREPARER) Preparer
signature
(IF INTERPRETER)
Interpreter certification

7.8

Preparer's signature upload

6.7

Interpreter's certification and signature

The applicant will need to scan and upload your completed signature page on the next screen.

Will remove (which is the beneficiary if filling
on behalf of him or herself) for MVP
Will remove (which is the beneficiary if filling
on behalf of him or herself) for MVP

Upload

I certify, under penalty of perjury, that: I am fluent in English and the language provided in the Getting Started section of this declaration, and I have read to
this individual agreeing to financially support the beneficiary in the identified language every question and instruction on this declaration and his or her
answer to every question. The individual agreeing to financially support the beneficiary informed me that he or she understands every instruction, question,
and answer on the declaration, including the Certification of the Individual Agreeing to Financially Support the Beneficiary, and has verified the accuracy
of every answer.

Scan and upload your preparer's completed signature page below.
Your interpreter must read and agree to the certification below.

As the applicant's interpreter, you must sign on paper and provide your signature page to the applicant. Follow these steps:

Specific to digital environment and part of
global template previously approved by OMB.

1. Download the Interpreter Signature page
2. Print the Interpreter Signature page
3. Read and sign the Interpreter Signature page
4. Give the signed Interpreter Signature page to the applicant
The applicant will need to scan and upload your completed signature page on the next screen.

(IF INTERPRETER)
Interpreter signature
Statement of the
individual agreeing to
financially support the
beneficiary

5.1.A

Individual agreeing to financially support the
beneficiary's statement

5.2

Individual agreeing to financially support the
beneficiary's statement regarding the preparer
Individual agreeing to financially support the
beneficiary's statement regarding the interpreter

5.1.B

(If "Statement of the
Individual agreeing to
financially support the
beneficiary" is
complete) Signature of
the individual agreeing to
financially support the
beneficiary

Upload

Scan and upload your interpreter's completed signature page below.

I, as the individual agreeing to financially support the beneficiary, certify the following:
I can read and understand English, and have read and understand every question and instruction on this declaration and my answer to every question.

Checkbox

You must read and agree to the statement below.

MVP
MVP

At my request, the preparer named in the Getting Started section of this declaration prepared this declaration for me based only upon the information I
provided or authorized.
The interpreter named in the Getting Started section of this declaration read to me every question and instruction on this declaration and my answer to every question in
the language I specified in the Getting Started section, a language in which I am fluent, and I understood everything.

Checkbox

You must read and agree to the statement below.

MVP

Checkbox

You must read and agree to the statement below.

MVP

Interpreter's signature upload

Form I-134 "Declaration of Individual agreeing to financially support the
Financial Support" - pages beneficiary's Certification
10

You must read and agree to the certification below. If you knowingly and willfully
falsify or conceal a material fact or submit a false document with your declaration,
we can deny your declaration and may deny any other immigration benefit. You may
also face criminal prosecution and penalties provided by the law.

Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS or the Department of State may require that
I submit original documents to USCIS or the Department of State at a later date. Furthermore, I authorize the release of any information from any and all of my records that
USCIS or the Department of State may need to determine my eligibility for the immigration benefit I seek.
I further authorize release of information contained in this declaration, in supporting documents, and in my USCIS or the Department of State records to other entities and
persons where necessary for the administration and enforcement of U.S. immigration laws.
I understand that USCIS may require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or
signature) and, at that time, if I am required to provide biometrics, I will be required to sign an oath reaffirming that:
1) I reviewed and provided or authorized all of the information in my declaration;
2) I understood all of the information contained in, and submitted with, my declaration; and
3) All of this information was complete, true, and correct at the time of filing
I certify, under penalty of perjury, that I provided or authorized all of the information in my declaration, I understand all of the
information contained in, and submitted with, my declaration, and that all of this information is complete, true, and correct.
That this declaration is made by me to assure the U.S. Government that the beneficiary named under the About Beneficiary section will be financially supported while in the
United States.
That I am willing and able to receive, maintain, and support the person named under the About Beneficiary section to better ensure that such persons will have
sufficient financial resources or financial support to pay for necessary expenses for the period of his or her temporary stay in the United States.
I acknowledge that I have read this section, and I am aware of my responsibilities as an individual agreeing to financially support the beneficiary
I have read and agree to the statement and certification of the individual agreeing to financially support the beneficiary.

Checkbox

Specific to digital environment and part of
global template previously approved by OMB.

Review & Submit

I-134: Review and Submit

Primary Nav

Secondary Nav

Tertiary Nav

Paper Form

Question

Sub-Question

Individual Agreeing to Financially Support the
Beneficiary's Signature
[Date of signature]
Submit the I-134

(If "Statement of the
Individual agreeing to
financially support the
beneficiary" and
"Individual Agreeing to
Financially Support the
Beneficiary's Signature"
are complete") Submit

( Successful submission)
(No nav)

You have successfully submitted Declaration of
Financial Support (I-134)

(Unsuccessful card
declined) (No nav)

You have successfully submitted Declaration of
Financial Support (I-134)

( Unsuccessful submission)
(No nav)

You have successfully submitted Declaration of
Financial Support (I-134)

Field Type

Instructional Text

Help Text

CTA

You must provide your digital signature below by typing your full legal name. If you do not
completely fill out this declaration, or if you do not submit the required documents listed in
the Instructions, we may deny your declaration. We will record the date of your signature
with your declaration.

Required field

Once you submit this declaration, you will receive a confirmation with details on any
next steps. We will record the date of your submission with the declaration. Your
case status will be updated on your and your client's account home page.

Submit

We will contact you if we have any questions or need additional information. You can track
the status of your declaration through your USCIS online account.
Your payment failed because your credit or debit card was declined.

Go to my
cases

You can try again now to sign and submit your declaration or save and exit.
Your payment failed or was canceled before it could be processed on Pay.gov.
You can try again now to sign and submit your declaration or save your declaration and exit.
We will save your declaration for 30 days from when you started it.

Notes

Sign and
submit

Sign and
submit

Review & Submit