Form I-361 - Affidavit Of Financial Support And Intent To Petition For Legal Custody Page 6
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1113. That the following persons are dependent upon me for support. (Place a check in the appropriate column to indicate whether
the person named is wholly or partially dependent upon you for support.)
Name of Person
Wholly
Partially
Age
Relationship to Me
Dependent
Dependent
14.
That I have previously submitted or am submitting affidavit(s) of support for the following person(s). If none, state "None."
Name
Date Submitted
Relationship
15.
That I have submitted visa petition(s) to USCIS on behalf of the following person(s). If none, state "None."
Name
Date Submitted
Relationship
Oath or Affirmation of Deponent
I swear (affirm) that I know the contents of this affidavit signed by me and the statements are true and correct.
Signature of deponent:
Subscribed and sworn to (affirmed) before me this
day of
at
Signature of immigration or consular office administering oath:
Title:
Submit This Form in Duplicate.
Form I-361 (Rev. 04/28/09)Y Page 3
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Parent category: Legal