The I-864A Affidavit of Support is a form used to establish a financial commitment between a sponsor and a household member of an intending immigrant. This document ensures that the household member agrees to support the immigrant financially, helping to meet the necessary income requirements set by U.S. immigration law. Understanding this form is crucial for those involved in the immigration process, so take the first step by filling out the form below.
The I-864A Affidavit of Support form plays a crucial role in the U.S. immigration process, particularly for individuals seeking to bring family members into the country. This form serves as a contract between a sponsor and a household member, outlining the financial responsibilities that the sponsor agrees to assume for the intending immigrant. It is essential for ensuring that the sponsored individuals do not become a public charge. The form requires detailed information about the household member, including their relationship to the sponsor, employment status, and financial history. It also necessitates the disclosure of income, assets, and tax information for the past three years. By signing the I-864A, the household member commits to supporting the sponsor's financial obligations, which may include joint liability for any debts incurred under the affidavit. This form not only reinforces the sponsor's promise to provide adequate support but also establishes a legal framework that underscores the importance of financial stability in the immigration process. Understanding the I-864A is vital for anyone involved in sponsoring an immigrant, as it lays the groundwork for a successful application and the well-being of the individuals being supported.
Contract Between Sponsor and Household Member
USCIS
Department of Homeland Security
Form I-864A
OMB No. 1615-0075
U.S. Citizenship and Immigration Services
Expires 12/31/2023
For Government Use Only
This Form I-864A relates to a household member who:
IS the intending immigrant
IS NOT the
Reviewed By:
intending
Location:
Date (mm/dd/yyyy):
immigrant
To be completed by an
Select this box if
Attorney State Bar Number
Attorney or Accredited Representative
Form G-28 or
(if applicable)
USCIS Online Account Number (if any)
attorney or accredited
G-28I is attached.
representative (if any).
►START HERE - Type or print in black ink.
Part 1. Information About You (the Household Member)
Physical Address
4.a. Street Number
and Name
Full Name
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
Mailing Address
(USPS ZIP Code Lookup)
2.a. In Care Of Name
4.b. Apt. 4.c. City or Town 4.d. State
4.f. Province
4.g. Postal Code
4.h. Country
Ste. Flr.
4.e. ZIP Code
2.b. Street Number
Other Information
2.c. Apt. 2.d. City or Town 2.e. State
2.g. Province
2.h. Postal Code
2.i. Country
2.f. ZIP Code
5.Date of Birth (mm/dd/yyyy)
Place of Birth 6.a. City or Town
6.b. State or Province
6.c. Country
3.Is your current mailing address the same as your physical
address?
Yes
No
If you answered "No" to Item Number 3., provide your physical address.
7.U.S. Social Security Number (if any)
►
8.USCIS Online Account Number (if any)
Form I-864A 12/08/21
Page 1 of 8
Part 2. Your (the Household Member's) Relationship to the Sponsor
Select Item Number 1.a., 1.b., or 1.c.
1.a.
I am the intending immigrant and also the sponsor's
spouse.
1.b.
I am the intending immigrant and also a member of
the sponsor's household.
1.c.
I am not the intending immigrant. I am the sponsor's
household member. I am related to the sponsor as
his/her:
Spouse
Son or Daughter (at least 18 years of age)
Parent
Brother or Sister
Other Dependent (Specify)
Part 3. Your (the Household Member's) Employment and Income
I am currently:
1. Employed as a/an
2.Name of Employer Number 1
3.Name of Employer Number 2 (if applicable)
4. Self employed as a/an
5. Retired from (Company Name)
Since (mm/dd/yyyy)
6. Unemployed since (mm/dd/yyyy)
7.My current individual annual income is:
$
Part 4. Your (the Household Member's) Federal Income Tax Information and Assets
1.a. Have you filed a Federal income tax return for each of the
three most recent tax years?
NOTE: You MUST attach a photocopy or transcript of
your Federal income tax return for only the most recent
tax year.
(Optional) I have attached photocopies or transcripts
of my Federal income tax returns for my second and
third most recent tax years.
My total income (adjusted gross income on IRS Form 1040EZ) as reported on my Federal income tax returns for the most recent three years was:
Tax Year
Total Income
2.a.
Most Recent
2.b.
2nd Most Recent
2.c.
3rd Most Recent
My assets (complete only if necessary).
3.a. Enter the balance of all cash, savings, and checking
accounts.$
3.b. Enter the net cash value of real-estate holdings. (Net value means assessed value minus mortgage debt.)
3.c. Enter the cash value of all stocks, bonds, certificates of deposit, and other assets not listed on Item Numbers 3.a.
or 3.b.
3.d. Add together Item Numbers 3.a., 3.b., and 3.c. and enter
the number here.
Part 5. Sponsor's Promise, Statement, Contact
Information, Declaration, Certification, and
Signature
NOTE: Read the Penalties section of the Form I-864A Instructions before completing this part.
I, THE SPONSOR,
,
(Print Name)
in consideration of the household member's promise to support the following intending immigrants and to be jointly and severally liable for any obligations I incur under the affidavit of support, promise to complete and file an affidavit of support on behalf of the following named intending immigrants.
(Indicate Number)
Page 2 of 8
Signature (continued)
Intending Immigrant Number 1
Name
2. Date of Birth (mm/dd/yyyy)
3.Alien Registration Number (A-Number, if any)
► A-
4.U.S. Social Security Number (if any)
5.USCIS Online Account Number (if any)
Intending Immigrant Number 2
6.a. Family Name
6.b. Given Name
6.c. Middle Name
7. Date of Birth (mm/dd/yyyy)
8.Alien Registration Number (A-Number, if any)
9.U.S. Social Security Number (if any)
10.USCIS Online Account Number (if any)
Intending Immigrant Number 3
11.a. Family Name
11.b. Given Name
11.c. Middle Name
12. Date of Birth (mm/dd/yyyy)
13.Alien Registration Number (A-Number, if any)
14.U.S. Social Security Number (if any)
15.USCIS Online Account Number (if any)
Intending Immigrant Number 4
16.a. Family Name
16.b. Given Name
16.c. Middle Name
17. Date of Birth (mm/dd/yyyy)
18.Alien Registration Number (A-Number, if any)
19.U.S. Social Security Number (if any)
20.USCIS Online Account Number (if any)
Intending Immigrant Number 5
21.a. Family Name
21.b. Given Name
21.c. Middle Name
22. Date of Birth (mm/dd/yyyy)
23.Alien Registration Number (A-Number, if any)
24.U.S. Social Security Number (if any)
25.USCIS Online Account Number (if any)
Sponsor's Statement
NOTE: Select the box for either Item Number 26.a. or 26.b. If applicable, select the box for Item Number 27.
26.a. I can read and understand English, and I have read and understand every question and instruction on this contract and my answer to every question.
Page 3 of 8
26.b. The interpreter named in Part 7. read to me every question and instruction on this contract and my answer to every question in
a language in which I am fluent, and I understood
everything.
27.
At my request, the preparer named in Part 8.,
prepared this contract for me based only upon information I provided or authorized.
Sponsor's Contact Information
28.Sponsor's Daytime Telephone Number
29.Sponsor's Mobile Telephone Number (if any)
30.Sponsor's Email Address (if any)
Sponsor's Declaration and Certification
Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that U.S. Citizenship and Immigration Services (USCIS) or the U.S. Department of State (DOS) may require that I submit original documents to USCIS or DOS at a later date. Furthermore, I authorize the release of any information from any and all of my records that USCIS or DOS may need to determine my eligibility for the immigration benefit that I seek.
I furthermore authorize release of information contained in this contract, in supporting documents, and in my USCIS or DOS records, to other entities and persons where necessary for the administration and enforcement of U.S. immigration law.
I certify, under penalty of perjury, that all of the information in my contract and any document submitted with it were provided or authorized by me, that I reviewed and understand all of the information contained in, and submitted with, my contract and that all of this information is complete, true, and correct.
Sponsor's Signature
31.a. Sponsor's Signature
31.b. Date of Signature (mm/dd/yyyy)
NOTE TO ALL SPONSORS: If you do not completely fill out this contract or fail to submit required documents listed in the Instructions, USCIS may deny your contract.
Part 6. Your (the Household Member's) Promise,
Statement, Contact Information, Declaration,
Certification, and Signature
I, THE HOUSEHOLD MEMBER,
in consideration of the sponsor's promise to complete and file an affidavit of support on behalf of the above named intending immigrants.
(Print number of intending immigrants noted in Part 5.
Sponsor's Promise, Statement, Contact Information, Declaration, Certification and Signature.)
A.Promise to provide any and all financial support necessary to assist the sponsor in maintaining the sponsored immigrants at or above the minimum income provided for in the Immigration and Naturalization Act (INA) section 213A(a)(1)(A) (not less than 125 percent of the Federal Poverty Guidelines) during the period in which the affidavit of support is enforceable;
B.Agree to be jointly and severally liable for payment of any and all obligations owed by the sponsor under the affidavit of support to the sponsored immigrants, to any agency of the Federal Government, to any agency of a state or local government, or to any other private entity that provides means-tested public benefits;
C.Certify under penalty under the laws of the United States that the Federal income tax returns submitted in support of the contract are true copies or unaltered tax transcripts filed with the Internal Revenue Service;
D.Consideration where the household member is also the sponsored immigrant: I understand that if I am the sponsored immigrant and a member of the sponsor's household that this promise relates only to my promise to be jointly and severally liable for any obligation owed by the sponsor under the affidavit of support to any of my dependents, to any agency of the Federal Government, to any agency of a state or local government, or to any other private entity that provides means-tested public benefits and to provide any and all financial support necessary to assist the sponsor in maintaining any of my dependents at or above the minimum income provided for in INA section 213A(a) (1)(A) (not less than 125 percent of the Federal Poverty Guideline) during the period which the affidavit of support is enforceable.
Page 4 of 8
Certification, and Signature (continued)
E.I understand that, if I am related to the sponsored immigrant or the sponsor by marriage, the termination of the marriage (by divorce, dissolution, annulment, or other legal process) will not relieve me of my obligations under this Form I-864A.
F.I authorize the Social Security Administration to release information about me in its records to the Department of State and U.S. Citizenship and Immigration Services (USCIS).
Your (the Household Member's) Statement
NOTE: Select the box for either Item Number 1.a. or 1.b. If applicable, select the box for Item Number 2.
I can read and understand English, and I have read
and understand every question and instruction on this
contract and my answer to every question.
The interpreter named in Part 7. read to me every
question and instruction on this contract and my
answer to every question in
2.
prepared this contract for me based only upon
information I provided or authorized.
Your (the Household Member's) Contact Information
3.Your (the Household Member's) Daytime Telephone Number
4.Your (the Household Member's) Mobile Telephone Number (if any)
5.Your (the Household Member's) Email Address (if any)
Your (the Household Member's) Declaration and Certification
Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS or DOS may require that I submit original documents to USCIS or DOS at a later date. Furthermore, I authorize the release of any information from any and all of my records that USCIS or DOS may need to determine my eligibility for the immigration benefit that I seek.
Your (the Household Member's) Signature
6.a. Your (the Household Member's) Printed Name
6.b. Your (the Household Member's) Signature
6.c. Date of Signature (mm/dd/yyyy)
NOTE TO ALL HOUSEHOLD MEMBERS: If you do not completely fill out this contract or fail to submit required documents listed in the Instructions, USCIS may deny your contract.
Part 7. Interpreter's Contact Information, Certification, and Signature
Provide the following information about the interpreter.
Interpreter's Full Name
1.a. Interpreter's Family Name (Last Name)
1.b. Interpreter's Given Name (First Name)
2.Interpreter's Business or Organization Name (if any)
Page 5 of 8
Part 7. Interpreter's Contact Information, Certification, and Signature (continued)
Interpreter's Mailing Address
Part 8. Contact Information, Declaration, and Signature of the Person Preparing this Contract, if Other Than the Sponsor or Household Member
Provide the following information about the preparer.
3.a. Street Number
3.b. Apt. 3.c. City or Town 3.d. State
3.f. Province
3.g. Postal Code
3.h. Country
3.e. ZIP Code
Preparer's Full Name
1.a. Preparer's Family Name (Last Name)
1.b. Preparer's Given Name (First Name)
2.Preparer's Business or Organization Name (if any)
Preparer's Mailing Address
Interpreter's Contact Information
4.Interpreter's Daytime Telephone Number
5.Interpreter's Mobile Telephone Number (if any)
6.Interpreter's Email Address (if any)
Interpreter's Certification
I certify, under penalty of perjury, that:
I am fluent in English and
which is the same language specified in Part 5., Item
Number 26.b. or Part 6., Item Number 1.b., and I have read
to this sponsor or household member in the identified language
every question and instruction on this contract and his or her
answer to every question. The sponsor or household member
informed me that he or she understands every instruction,
question, and answer on the contract, including the Sponsor's
or Household Member's Declaration and Certification, and
has verified the accuracy of every answer.
Interpreter's Signature
7.a. Interpreter's Signature
7.b. Date of Signature (mm/dd/yyyy)
Preparer's Contact Information
4.Preparer's Daytime Telephone Number
5.Preparer's Mobile Telephone Number (if any)
6.Preparer's Email Address (if any)
Page 6 of 8
(continued)
Preparer's Statement
7.a.
7.b.
I am not an attorney or accredited representative but have prepared this contract on behalf of the sponsor and household member and with the sponsor's or household member's consent.
I am an attorney or accredited representative and my representation of the sponsor and household member in this case extends does not extend beyond
the preparation of this contract.
NOTE: If you are an attorney or accredited representative, you may be obliged 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, with this contract.
Preparer's Certification
By my signature, I certify, under penalty of perjury, that I prepared this contract at the request of the sponsor and household member. The sponsor and household member then reviewed this completed contract and informed me that he or she understands all of the information contained in, and submitted with, his or her contract, including the Sponsor's or Household Member's Declaration and Certification, and that all of this information is complete, true, and correct. I completed this contract based only on information that the sponsor and household member provided to me or authorized me to obtain or use.
Preparer's Signature
8.a. Preparer's Signature
8.b. Date of Signature (mm/dd/yyyy)
Page 7 of 8
Part 9. Additional Information
If you need extra space to provide any additional information within this contract, use the space below. If you need more space than what is provided, you may make copies of this page to complete and file with this contract 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.
1.a. Family Name (Last Name)
1.b. Given Name (First Name)
2.A-Number (if any)
3.a. Page Number 3.b. Part Number 3.c. Item Number
3.d.
4.a. Page Number 4.b. Part Number 4.c. Item Number
4.d.
5.a. Page Number 5.b. Part Number 5.c. Item Number
5.d.
6.a. Page Number 6.b. Part Number 6.c. Item Number
6.d.
7.a. Page Number 7.b. Part Number 7.c. Item Number
7.d.
Page 8 of 8
Completing the I-864A Affidavit of Support form is an important step in the immigration process. This form must be filled out accurately to ensure that all necessary information is provided. Once the form is completed, it should be submitted along with any required documents to the appropriate government agency.
Form I-864A, Affidavit of Support, is used to demonstrate that a household member of a sponsor can contribute financially to support an intending immigrant. This form ensures that the immigrant will not become a public charge and helps establish the financial capability of the household to support the immigrant.
The form must be completed by a household member of the sponsor who is also financially supporting the intending immigrant. This includes spouses, children over 18, parents, or other relatives who reside in the same household and will contribute to the financial support of the immigrant.
Form I-864A requires personal information such as:
Additionally, the household member must declare their relationship to the sponsor and agree to financially support the intending immigrant.
The household member must demonstrate that their income, when combined with the sponsor's income, meets at least 125% of the Federal Poverty Guidelines for the household size. This ensures that the immigrant will have adequate financial support and will not rely on government assistance.
If the form is not fully completed or contains inaccuracies, U.S. Citizenship and Immigration Services (USCIS) may deny the application. It is crucial to provide accurate information and submit all required documents to avoid delays or denials in the immigration process.
Once Form I-864A is submitted, the household member is legally obligated to support the immigrant for the duration of the affidavit’s enforceability. Withdrawal of support is not permitted, even if the relationship with the sponsor changes, such as through divorce.
Completing the I-864A Affidavit of Support form can be a daunting task, and many individuals make common mistakes that can lead to delays or denials. One frequent error occurs when applicants fail to provide accurate personal information. This includes missing or incorrect names, addresses, or Social Security numbers. Such inaccuracies can create confusion and may require additional follow-up with U.S. Citizenship and Immigration Services (USCIS), prolonging the process unnecessarily.
Another mistake involves the financial information section. Applicants often misreport their income or fail to include necessary documentation. For instance, not attaching the required tax returns or transcripts for the last three years can lead to complications. It is essential to ensure that all financial details are complete and that the appropriate documents are submitted. This step is crucial, as USCIS relies on this information to assess the financial capability of the household member.
Furthermore, individuals sometimes overlook the importance of selecting the correct relationship to the sponsor. Misidentifying oneself as the intending immigrant or incorrectly stating the nature of the relationship can have significant implications. It is vital to carefully review the options provided in the form and select the one that accurately reflects the relationship to the sponsor.
Finally, many applicants neglect to sign and date the form appropriately. This may seem like a minor detail, but without a signature, the application is considered incomplete. Both the household member and the sponsor must ensure that their signatures are present and that the dates correspond to when the form was filled out. This attention to detail can prevent unnecessary delays in processing the application.
The I-864A Affidavit of Support form is an important document used in the immigration process. When completing this form, there are several other documents that may also be required to support the application. Below is a list of five commonly used forms and documents that often accompany the I-864A.
Gathering these documents is crucial for a successful application process. Each document plays a significant role in demonstrating financial responsibility and eligibility for immigration benefits. Make sure to review each requirement carefully to ensure all necessary documentation is included.
When filling out the I-864A Affidavit of Support form, it is crucial to adhere to certain guidelines to ensure the process goes smoothly. Below is a list of things you should and should not do.
Understanding the I-864A Affidavit of Support form can be challenging, and several misconceptions often arise. Here are eight common myths, along with clarifications to help you navigate this important document.
Many believe that only the primary sponsor needs to fill out this form. In reality, the I-864A is specifically for household members who will contribute to the financial support of the intending immigrant.
This is not true. By signing the I-864A, household members agree to be jointly responsible for supporting the immigrant, which means they can be held accountable for financial obligations.
In fact, the I-864A requires detailed income and employment information. This is crucial for determining whether the household meets the financial requirements to support the immigrant.
Household members can be lawful permanent residents or U.S. citizens. As long as they live in the same household as the sponsor, they can complete the I-864A.
This is a misconception. If a household member's income is being used to meet the financial requirements, their completion of the I-864A is mandatory.
Not quite. The form requires that household members provide their federal income tax returns for the most recent tax year to demonstrate financial stability.
Contrary to this belief, if a household member is also the spouse of the sponsor, their obligations do not automatically end with a divorce or separation.
This is misleading. While the immigrant's employment may help, the I-864A ensures that the household member is also committed to providing financial support, regardless of the immigrant's job status.
Being informed about these misconceptions can help you navigate the I-864A process more effectively. Understanding your responsibilities and the requirements can make a significant difference in the immigration journey.
Filling out the I-864A Affidavit of Support form is an important step in the immigration process. Here are key takeaways to consider: