Form I-864 - Affidavit Of Support Under Section 213a Of The Act Page 2
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9Part 3. Information on the Immigrant(s) You Are Sponsoring
1.
I am sponsoring the principal immigrant named in Part 2.
Family Member 3
4.a. Family Name
Yes
No (Applicable only in cases with two
(Last Name)
joint sponsors)
4.b. Given Name
2.
I am sponsoring the following family members
(First Name)
immigrating at the same time or within 6 months of
4.c. Middle Name
the principal immigrant named in Part 2. Do not
include any relative listed on a separate visa petition.
4.d. Relationship to Sponsored Immigrant
Family Member 1
2.a.
Family Name
►
(Last Name)
4.e.
Date of Birth
(mm/dd/yyyy)
2.b. Given Name
4.f.
Alien Registration Number (A-Number)
(First Name)
►
A-
2.c. Middle Name
2.d. Relationship to Sponsored Immigrant
►
2.e.
Date of Birth
(mm/dd/yyyy)
Family Member 4
5.a.
Family Name
2.f.
Alien Registration Number (A-Number)
(Last Name)
►
A-
5.b.
Given Name
(First Name)
5.c.
Middle Name
5.d.
Relationship to Sponsored Immigrant
Family Member 2
3.a.
Family Name
(mm/dd/yyyy) ►
(Last Name)
5.e. Date of Birth
3.b.
Given Name
5.f.
Alien Registration Number (A-Number)
(First Name)
►
A-
3.c.
Middle Name
3.d.
Relationship to Sponsored Immigrant
(mm/dd/yyyy) ►
3.e. Date of Birth
Family Member 5
6.a.
Family Name
3.f.
Alien Registration Number (A-Number)
(Last Name)
►
A-
6.b.
Given Name
(First Name)
Middle Name
6.c.
Form I-864 03/22/13 N
Page 2 of 9
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