I-134, Affidavit Of Support Instructions printable pdf download

OMB No. 1615-0014; Exp. 04-30-07

Department of Homeland Security

I-134, Affidavit of Support

U.S. Citizenship and Immigration Services

Instructions

I. Execution of Affidavit.

Statement of your employer on business stationery,

revealing:

A separate affidavit must be submitted for each person. As

1. Date and nature of employment;

the sponsor, you must sign the affidavit in your full, true

2. Salary paid;

and correct name and affirm or make it under oath.

3. Whether the position is temporary or permanent.

If you are in the United States, the affidavit may be

C. If self-employed:

sworn to or affirmed before an officer of U.S.

1. Copy of last income tax return filed; or

Citizenship and Immigration Services (USCIS)

2. Report of commercial rating concern.

without the payment of fee, or before a notary public

or other officers authorized to administer oaths for

D. List containing serial numbers and denominations of

general purposes, in which case the official seal or

bonds and name of record owner(s).

certificate of authority to administer oaths must be

affixed.

III. Sponsor and Alien Liability.

If you are outside the United States, the affidavit

Effective October 1, 1980, amendments to section 1614(f) of

must be sworn to or notice affirmed before a U.S.

the Social Security Act and Part A of Title XVI of the Social

consular or immigration officer.

Security Act establish certain requirements for determining

the eligibility of aliens who apply for the first time for

Supplemental Security Income (SSI) benefits.

How you submit the form depends on whether the alien

you are sponsoring is in or outside the United States and

Effective October 1, 1981, amendments to section 415 of the

what type of application is being submitted. See the

Social Security Act established similar requirements for

instructions provided with the corresponding application

determining the eligibility of aliens who apply for the first

for detailed information on how to submit this affidavit of

time for Aid to Families with Dependent Children (AFDC),

support form.

currently administered under Temporary Assistance for

Needy Families (TANF). Effective December 22, 1981,

amendents to the Food Stamp Act of 1977 affect the

II. Supporting Evidence.

eligibility of alien participation in the Food Stamp Program.

As the sponsor, you must show you have sufficient income

These amendments require that the income and resources of

and/or financial resources to assure that the alien you are

any person, who as the sponsor of an alien's entry into the

sponsoring will not become a public charge while in the

United States, executes an affidavit of support or similar

United States.

agreement on behalf of the alien, and the income and

resources of the sponsor's spouse (if living with the

Evidence should consist of copies of any or all of the

sponsor) shall be deemed to be the income and resources of

following documentation listed below that are applicable to

the alien under formulas for determining eligibility for SSI,

your situation.

TANF and Food Stamp benefits during the three years

following the alien's entry into the United States.

Failure to provide evidence of sufficient income and/or

financial resources may result in the denial of the alien's

Documentation on Income and Resources.

application for a visa or his or her removal from the United

An alien applying for SSI must make available to the Social

States.

Security Administration documentation concerning his / her

The sponsor must submit in duplicate evidence of income

income and resources and those of the sponsor, including

and resources, as appropriate:

information that was provided in support of the

corresponding application.

A. Statement from an officer of the bank or other financial

institutions where you have deposits, identifying the

An alien applying for TANF or Food Stamps must make

following details regarding your account:

similar information available to the State public assistance

agency.

1. Date account opened;

2. Total amount deposited for the past year;

The Secretary of Health and Human Services and the

3. Present balance.

Secretary of Agriculture are authorized to obtain copies of

any such documentation submitted to USCIS or the U.S.

Department of State and to release such documentation to a

State public assistance agency.

Form I-134 (Rev. 07/14/06)Y

I-134, Affidavit Of Support Instructions

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