Form I-864ez - Affidavit Of Support Under Section 213a Of The Act Page 6
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7Preparer's Contact Information
Part 7. Interpreter's Contact Information,
Certification, and Signature (continued)
4.
Preparer's Daytime Telephone Number
The sponsor has informed me that he or she understands every
instruction and question on the affidavit, as well as the answer
5.
Preparer's Fax Number
to every question, and the sponsor verified the accuracy of
every answer.
6.
Preparer's Email Address (if any)
Interpreter's Signature
6.a.
Interpreter's Signature
Preparer's Statement
I am not an attorney or accredited representative but
7.a.
6.b.
Date of Signature
(mm/dd/yyyy)
have prepared this affidavit on behalf of the sponsor
and with the sponsor's consent.
Part 8. Contact Information, Statement,
I am an attorney or accredited representative and my
7.b.
representation of the sponsor in this case
Certification, and Signature of the Person
extends
does not extend beyond the
Preparing this Affidavit, If Other Than the
preparation of this affidavit.
Sponsor
NOTE: If you are an attorney or accredited representative
whose representation extends beyond preparation of this
Provide the following information about the preparer.
affidavit, you must submit a completed Form G-28, Notice of
Preparer's Full Name
Entry of Appearance as Attorney or Accredited Representative,
with this affidavit.
1.a. Preparer's Family Name (Last Name)
Preparer's Certification
By my signature, I certify, swear, or affirm, under penalty of
1.b.
Preparer's Given Name (First Name)
perjury, that I prepared this affidavit on behalf of, at the request
of, and with the express consent of the sponsor. I completed
this affidavit based only on responses the sponsor provided to
2.
Preparer's Business or Organization Name (if any)
me. After completing the affidavit, I reviewed it and all of the
responses with the sponsor, who agreed with every answer on
the affidavit. If the sponsor supplied additional information
Preparer's Mailing Address
concerning a question on the affidavit, I recorded it on the
affidavit.
3.a.
Street Number
and Name
Preparer's Signature
3.b.
Apt.
Ste.
Flr.
8.a. Preparer's Signature
3.c. City or Town
3.d. State
3.e. ZIP Code
8.b. Date of Signature (mm/dd/yyyy)
3.f.
Province
3.g.
Postal Code
3.h.
Country
Form I-864EZ 07/02/15 N
Page 6 of 7
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