Instructions For Form I-864ez - Affidavit Of Support Under Section 213a Of The Ina (Page 10 of 11) in pdf

Instructions For Form I-864ez - Affidavit Of Support Under Section 213a Of The Ina Page 10

USCIS Privacy Act Statement

AUTHORITIES: The information requested on this affidavit, and the associated evidence, is contained in 8 U.S.C.

1182a(4), 1183a, 1184(a), and 1258.

PURPOSE: The primary purpose for providing the requested information on this affidavit is to determine if you have

established eligibility for the immigration benefit for which you are filing. DHS will use the information you provide to

grant or deny the immigration benefit you are seeking.

DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and

any requested evidence, may delay a final decision in your case or result in denial of your affidavit.

ROUTINE USES: DHS may share the information you provide on this affidavit with other Federal, state, local,

and foreign government agencies and authorized organizations. DHS follows approved routine uses described in the

associated published system of records notices [DHS-USCIS-007- Benefits Information System and DHS-USCIS-001-

Alien File, Index, and National File Tracking System of Records] which you can find at DHS

may also make the information available, as appropriate, for law enforcement purposes or in the interest of national

security.

Paperwork Reduction Act

An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection

of information, unless it displays a currently valid OMB control number. The public reporting burden for this collection

of information is estimated at 2 hours and 30 minutes per response, including the time for reviewing instructions,

gathering the required documentation and information, completing the affidavit, preparing statements, attaching necessary

documentation, and submitting the affidavit. Send comments regarding this burden estimate or any other aspect of this

collection of information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services,

Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave NW, Washington, DC 20529-2140;

OMB No. 1615-0075. Do not mail your completed Form I-864EZ to this address.

Form I-864EZ Instructions 07/02/15 N

Page 10 of 11

Instructions For Form I-864ez - Affidavit Of Support Under Section 213a Of The Ina Page 10