Form I-864ez - Affidavit Of Support Under Section 213a Of The Act Page 7
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75.a. Page Number
5.b. Part Number
5.c. Item Number
Part 9. Additional Information
If you need extra space to provide any additional information
within this affidavit, use the space below. If you need more
5.d.
space than what is provided, you may make copies of this page
to complete and file with this affidavit or attach a separate sheet
of paper. Include your name and A-Number (if any) at the top
of each sheet; indicate the Page Number, Part Number, and
Item Number to which your answer refers; and sign and date
each sheet.
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
2.
A-Number (if any)
A-
6.a. Page Number
6.b. Part Number
6.c. Item Number
3.a. Page Number
3.b. Part Number
3.c. Item Number
6.d.
3.d.
4.a. Page Number
4.b. Part Number
4.c. Item Number
4.d.
Form I-864EZ 07/02/15 N
Page 7 of 7
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