Form I-361 - Affidavit Of Financial Support And Intent To Petition For Legal Custody For Public Law 97-359 Amerasian

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Affidavit of Financial Support and Intent to Petition for Legal
Custody of Public Law 97-359 Amerasian
Department of Homeland Security
USCIS
U.S. Citizenship and Immigration Services
Form I-361
► START HERE - Type or print in black ink.
Part 1. Information About You (Sponsor)
Mailing Address
1.a. Family Name
9.a.
In Care of Name
(Last Name)
1.b. Given Name
(First Name)
Street Number
9.b.
and Name
1.c. Middle Name
9.c.
Apt.
Ste.
Flr.
2.
Date of Birth (mm/dd/yyyy)
9.d.
City or Town
3.a. City of Birth
9.e.
State
9.f.
ZIP Code
3.b. Country of Birth
9.g.
Province
9.h.
Postal Code
4.
Alien Registration Number (A-Number) (if any)
►
9.i.
Country
A-
5.
U.S. Social Security Number (if any)
►
Information About Citizenship
6.
USCIS ELIS Account Number (if any)
10.
Are you a U.S. citizen?
Yes
No
►
11.
How did you acquire your U.S. citizenship?
Physical Address
Birth
Parents
Naturalization
Other
7.a.
Street Number
12.a. If you acquired your U.S. citizenship through your
and Name
parents, have you obtained a Certificate of Citizenship in
your own name?
7.b.
Apt.
Ste.
Flr.
Yes
No
If you answered "Yes," provide the following information
7.c.
City or Town
about your Certificate of Citizenship:
7.d.
State
7.e. ZIP Code
12.b.
Name Under Which the Certificate of Citizenship Was
Issued
7.f.
Province
Family Name
(Last Name)
7.g.
Postal Code
Given Name
(First Name)
7.h.
Country
Middle Name
8.
Are your physical address and mailing address the same?
12.c. Certificate of Citizenship Number
Yes
No
If you answered "No" to Item Number 8., provide your
12.d.
Date of Issuance (mm/dd/yyyy)
mailing address in Item Numbers 9.a. - 9.i.
12.e. Place of Issuance
Form I-361 09/11/15 N
Page 1 of 8

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