Form I-864ez - Affidavit Of Support Under Section 213a Of The Act Page 4
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11C. You intend in good faith to reestablish your domicile in
credited work in the United States, or obtaining a new grant of
the United States no later than the date of the intending
adjustment of status while in removal proceedings based on a
immigrant's admission or adjustment of status. You must
new affidavit of support, if one is required.
submit proof that you have taken concrete steps to establish
16(e) - Enter the number of any other dependents. You must
you will be domiciled in the United States at a time no later
include each and every person whom you have claimed as a
than the date of the intending immigrant's admission or
dependent on your most recent Federal income tax return,
adjustment of status. Concrete steps might include accepting a
even if that person is not related to you. Even if you are not
job in the United States, signing a lease or purchasing a
legally obligated to support that person, you must include the
residence in the United States, or registering children in U.S.
person if in fact you did support that person and claimed the
schools. Please attach proof of the steps you have taken to
person as a dependent.
establish domicile as previously described.
Part 5. Sponsor's Income and Employment.
15. Military Service.
18. Current Individual Annual Income.
Check "yes" if you are the petitioning sponsor and on active
duty in the U.S. Army, Navy, Air Force, Marines, or Coast
Enter your current individual earned or retirement annual
Guard, other than for training. If you provide evidence that
income that you are using to meet the requirements of this
you are currently on active duty in the military and you are
form and indicate the total on this line.
petitioning for your spouse or minor child, you will need to
demonstrate income at only 100 percent of the poverty level
You may include evidence supporting your claim about your
for your household size, instead of at 125 percent of the
expected income for the current year if you believe that
poverty level. (See Form I-864P for information on the
submitting this evidence will help you establish ability to
poverty levels.) Check "no" if you are not on active duty in
maintain sufficient income. You are not required to submit
the U.S. military.
this evidence, however, unless specifically instructed to do
so by a Government official. For example, you may include
a recent letter from your employer, showing your employer's
Part 4. Sponsor's Household Size.
address and telephone number, and indicating your annual
salary. You may also provide pay stub(s) showing your
This section asks you to add together the number of persons
income for the previous six months. If your claimed income
for whom you are financially responsible. Some of these
includes alimony, child support, dividend or interest income,
persons may not be residing with you. Make sure you do not
or income from any other source, you may also include
count any individual more than once, since in some cases the
evidence of that income.
same person could fit into two categories.
19. Federal Income Tax Information.
16(a) - This line is already completed for you.
You must provide either an IRS transcript or a photocopy
16(b) - If you are married, and your spouse was not included
from your own records of your Federal individual income tax
in line (a), enter "1" here.
return for the most recent tax year. If you believe additional
returns may help you to establish your ability to maintain
16(c) - Enter the number of unmarried children you have who
sufficient income, you may submit transcripts or photocopies
are under age 21, even if you do not have legal custody of
of your Federal individual income tax returns for the 3 most
these children. You may exclude any unmarried children
recent years.
under 21, if these children have reached majority under the
law of their place of domicile and you do not claim them as
You are not required to have the IRS certify the transcript or
dependents on your income tax returns.
photocopy unless specifically instructed to do so by a
Government official; a plain transcript or photocopy is
16(d) - Enter the number of lawful permanent residents whom
acceptable. Telefile tax records are not acceptable proof of
you are currently obligated to support based on your previous
filing.
submission of Form I-864 or Form I-864EZ as a petitioning,
substitute, or joint sponsor. Include only those persons who
Do not submit copies of your State income tax returns. Do
have already immigrated to the United States. Do not include
not submit any tax returns that you filed with any foreign
anyone for whom your obligation to support has ended
government unless you claim that you were not required to
through the sponsored immigrant's acquisition of U.S.
file a Federal tax return with the United States government
citizenship, death, abandonment of lawful permanent residence
and you wish to rely on the foreign return solely to establish
in the United States, aquisition of 40 quarters of earned or
the amount of your income that is not subject to tax in the
United States.
Form I-864EZ Instructions (09/19/11) Y Page 4
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