Information On Sponsor (Person Filing The Form I-864) (Page 2 of 3) in pdf

Information On Sponsor (Person Filing The Form I-864) Page 2

List any spouse and/or children immigrating with the immigrant named above in this Part:

Name

Relationship to Sponsored Immigrant (Ex. Spouse, Son, Daughter, etc.)

Date of Birth (Month/ Day/ Year)

A-Number (If Any)

Social Security Number (If Any)

Name

Relationship to Sponsored Immigrant (Ex. Spouse, Son, Daughter, etc.)

Date of Birth (Month/ Day/ Year)

A-Number (If Any)

Social Security Number (If Any)

Name

Relationship to Sponsored Immigrant (Ex. Spouse, Son, Daughter, etc.)

Date of Birth (Month/ Day/ Year)

A-Number (If Any)

Social Security Number (If Any)

Name

Relationship to Sponsored Immigrant (Ex. Spouse, Son, Daughter, etc.)

Date of Birth (Month/ Day/ Year)

A-Number (If Any)

Social Security Number (If Any)

SPONSOR'S EMPLOYMENT

I am:

1) Employed by ___________________________________________ (Provide evidence of employment)

Annual salary $__________________ or hourly wage $______________ (for _____________ hours per week)

2) Self employed _________________________________________________________ (Name of business)

Nature of employment or business _____________________________________________________________

3) Unemployed or retired since ___________________________________________________________________

SPONSOR'S HOUSEHOLD SIZE

1. Number of persons (related to you by birth, marriage, or adoption) living in your residence, INCLUDING YOURSELF

(NOTE: DO NOT include persons being sponsored in this affidavit.)

(Circle One: 1, 2, 3, 4, 5, 6, 7)

2. Number of immigrants being sponsored in this affidavit

(Circle One: 1, 2, 3, 4, 5, 6, 7)

3. Number of immigrants NOT living in your household whom you are obligated to support under a previously signed Form I-864.

(Circle One: 0, 1, 2, 3, 4, 5, 6, 7)

4. Number of persons who are OTHERWISE dependent on you, as claimed in your tax return for the most recent tax year.

(Circle One: 0, 1, 2, 3, 4, 5,

6, 7)

Total: ______________

5. Total household size. (Add lines 1 through 4.)

Information On Sponsor (Person Filing The Form I-864) Page 2