Looking for a Uscis Forms And Templates? Download it for free!

Copies. You may submit legible photocopies of documents requested, unless the instructions specifically state that you

must submit an original document. USCIS may request an original document at the time of filing or at any time during

processing of an application, petition, or request. If you submit original documents when not required, the documents

may remain a part of the record, and USCIS will not automatically return them to you.

Translations. If you submit a document with information in a foreign language, you must also submit a full English

translation. The translator must sign a certification that the English language translation is complete and accurate, and that

he or she is competent to translate from the foreign language into English.

How To Fill Out Form I-864W

1. Type or print legibly in black ink.

2. If you need extra space to complete any item within this request, use the space provided in Part 6. Additional

Information or attach a separate sheet of paper; type or print your name and Alien Registration Number (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.

3. Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been

married and the question asks “Provide the name of your current spouse”), type or print “N/A,” unless otherwise

directed. If your answer to a question which requires a numeric response is zero or none (for example, “How many

children do you have” or “How many times have you departed the United States”), type or print “None,” unless

otherwise directed.

4. USCIS ELIS Account Number (if any). If you have previously filed an application, petition, or request using the

USCIS Electronic Immigration System (USCIS ELIS), provide the USCIS ELIS Account Number you were issued by

the system. The USCIS ELIS Account Number is not the same as an A-Number. If you were issued a USCIS ELIS

Account Number, enter it in the space provided.

5. Part 3. Requestor’s (Intending Immigrant’s) Statement, Contact Information, Certification, and Signature.

Select the appropriate box to indicate that you either read this request yourself or someone interpreted this request for

you from English to a language in which you are fluent. If applicable, select the box to indicate if someone prepared

this request for you. Further, you must sign and date your request and provide your daytime telephone number,

mobile telephone number (if any), and email address (if any). Every request MUST contain the signature of the

requestor (or parent or legal guardian, if applicable). A stamped or typewritten name in place of a signature is not

acceptable.

6. Part 4. Interpreter’s Contact Information, Certification, and Signature. If you used anyone as an interpreter to

read the Instructions and questions on this request to you in a language in which you are fluent, the interpreter must

fill out this section, provide his or her name, the name and address of his or her business or organization (if any), his

or her daytime telephone number, and his or her email address (if any). The interpreter must sign and date the request.

7. Part 5. Contact Information, Statement, Certification, and Signature of the Person Preparing this Request,

If Other Than the Requestor. This section must contain the signature of the person who completed your request,

if other than you, the requestor. If the same individual acted as your interpreter and your preparer, that person

should complete both Part 4. and Part 5. If the person who completed this request is associated with a business

or organization, that person should complete the business or organization name and address information. Anyone

who helped you prepare this request MUST sign and date the request. A stamped or typewritten name in place

of a signature is not acceptable. If the person who helped you prepare your request is an attorney or accredited

representative, he or she must also submit a completed Form G-28, Notice of Entry of Appearance as Attorney or

Accredited, along with your request.

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

Page 3 of 6

Instructions For Form I-864w - Request For Exemption For Intending Immigrant'S Affidavit Of Support Page 3