Form I-361 - Affidavit Of Financial Support And Intent To Petition For Legal Custody For Public Law 97-359 Amerasian Page 5
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8That, if the person named in Part 2. Information About
Part 4. Sponsor's Statement, Contact
Beneficiary is under 18 years of age, I agree to petition the
Information, Certification, and Signature
court having jurisdiction, within 30 days of the named person's
(continued)
arrival in the United States, to gain legal custody according to
the laws of the state where he or she will reside until he or she is
2.
I have requested the services of and consented to
18 years of age.
,
That, if the person named in Part 2. Information About
who
is
is not an attorney or accredited
Beneficiary is under 18 years of age, I agree to pay the interim
representative, preparing this affidavit for me.
costs incurred by that person from the time he or she is released
for immigration by his or her mother or legal guardian until I
Sponsor's Contact Information
am awarded legal custody of him or her.
3.
Sponsor's Daytime Telephone Number
That, if the person named in Part 2. Information About
Beneficiary is 18 years of age or older, I agree to pay the
interim costs involved in his or her travel to the United States.
4.
Sponsor's Mobile Telephone Number (if any)
That I understand that the Secretary of Homeland Security may
enforce this guarantee of financial support and intent to petition
Sponsor's Email Address (if any)
for legal custody for the person named in Part 2. Information
5.
About Beneficiary against me in a civil suit in the United
States district court of the district in which I reside. However, I
or my estate will not be liable under this guarantee if I die or am
Sponsor's Certification
adjudicated as bankrupt under Title 11, United States Code.
Copies of any documents I have submitted are exact
That I understand that USCIS may make the information and
photocopies of unaltered, original documents, and I understand
documentation provided by me available to the Secretary of
that USCIS may require that I submit original documents to
Health and Human Services, the Secretary of Agriculture, or the
USCIS at a later date. Furthermore, I authorize the release of
Food and Nutrition Service, for use in determination of public
any information from any and all of my records that USCIS
assistance.
may need to determine my eligibility for the immigration
That I have read the Form 1-361 Instructions and am aware of
benefit that I seek.
my responsibilities under the Social Security Act as amended,
I furthermore authorize release of information contained in this
the Food Stamp Act, and Public Law 97-359.
affidavit, in supporting documents, and in my USCIS records,
That under penalty of perjury, that the information in my
to other entities and persons where necessary for the
affidavit and any document submitted with my affidavit were
administration and enforcement of U.S. immigration laws.
provided by me and are complete, true, and correct.
I certify:
Sponsor's Signature
That this affidavit is made by me to assure the U.S. Government
that the person named in Part 2. Information About
6.a.
Sponsor's Signature
Beneficiary will not become a public charge in the United
States.
6.b. Date of Signature (mm/dd/yyyy)
That I am willing and able to receive, maintain, and support the
person named in Part 2. Information About Beneficiary, and
NOTE TO ALL SPONSORS: If you do not completely fill
that I agree to furnish financial support during the entire 5-year
out this affidavit or fail to submit required documents listed in
period beginning on the date the named person acquires the
the Instructions, USCIS may reject your affidavit.
status of a lawful permanent resident and ending on the date on
which the named person becomes 21 years of age, whichever
period is longer. The financial support that I furnish is
sufficient to maintain my family, including the named person, in
the United States, at a level equal to at least 125 percent of the
current official poverty line (as established by the Director of
the Office of Management and Budget, under Section 673(2) of
the Omnibus Budget Reconciliation Act of 1981 and as revised
by the Secretary of Health and Human and Services under
section 652 of that Act) for my family size, including the named
person.
Form I-361 09/11/15 N
Page 5 of 8
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