Uscis I-864 Real Estate Consulting Agreement Page 11
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12I am an attorney or accredited representative and my
7.b.
Part 10. Contact Information, Statement,
representation of the sponsor in this case
Certification, and Signature of the Person
extends
does not extend beyond the
Preparing this Affidavit, If Other Than the
preparation of this affidavit.
Sponsor (continued)
NOTE: If you are an attorney or accredited
representative whose representation extends beyond
Preparer's Mailing Address
preparation of this affidavit, you must submit a
completed Form G-28, Notice of Entry of
3.a.
Street Number
Appearance as Attorney or Accredited
and Name
Representative, with this affidavit.
3.b.
Apt.
Ste.
Flr.
Preparer's Certification
3.c. City or Town
By my signature, I certify, swear, or affirm, under penalty of
3.d. State
3.e. ZIP Code
perjury, that I prepared this affidavit on behalf of, at the request
of, and with the express consent of the sponsor. I completed
3.f.
Province
this affidavit based only on responses the sponsor provided to
me. After completing the affidavit, I reviewed it and all of the
3.g.
Postal Code
responses with the sponsor, who agreed with every answer on
the affidavit. If the sponsor supplied additional information
3.h.
Country
concerning a question on the affidavit, I recorded it on the
affidavit.
Preparer's Contact Information
Preparer's Signature
4.
Preparer's Daytime Telephone Number
8.a. Preparer's Signature
5.
Preparer's Fax Number
8.b. Date of Signature (mm/dd/yyyy)
6.
Preparer's Email Address (if any)
Preparer's Statement
I am not an attorney or accredited representative but
7.a.
have prepared this affidavit on behalf of the sponsor
and with the sponsor's consent.
Form I-864 07/02/15 N
Page 11 of 12
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