Uscis I-864 Real Estate Consulting Agreement Page 7

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Household Size
Poverty Guideline
Sponsor's Household Income
(Page 5, Line 10)
Year: 2 0
Poverty Line:
The total value of all assets, line 10, must equal 5 times (3 times for spouses and children of
USC's, or 1 time for orphans to be formally adopted in the U.S.) the difference between the
poverty guidelines and the sponsor's household income, line 10.
What is the Legal Effect of My Signing Form I-864?
Part 7. Use of Assets to Supplement Income
(Optional) (continued)
If you sign Form I-864 on behalf of any person (called the
intending immigrant) who is applying for an immigrant visa or
Enter the net cash value of all the sponsored immigrant's
for adjustment of status to a lawful permanent resident, and that
real estate holdings. (Net value means investment value
intending immigrant submits Form I-864 to the U.S.
minus mortgage debt.)
Government with his or her application for an immigrant visa or
adjustment of status, under INA section 213A, these actions
create a contract between you and the U.S. Government. The
Enter the current cash value of the sponsored immigrant's
intending immigrant becoming a lawful permanent resident is
stocks, bonds, certificates of deposit, and other assets not
the consideration for the contract.
included in Item Number 6. or Item Number 7.
Under this contract, you agree that, in deciding whether the
intending immigrant can establish that he or she is not
Add together Item Numbers 6. - 8. and enter the
inadmissible to the United States as a person likely to become a
number here.
public charge, the U.S. Government can consider your income
and assets as available for the support of the intending
Total Value of Assets
Add together Item Numbers 4., 5.b., and 9. and enter
What If I Choose Not to Sign Form I-864?
the number here.
The U.S. Government cannot make you sign Form 1-864 if you
do not want to do so. But if you do not sign Form I-864, the
intending immigrant may not become a lawful permanent
resident in the United States.
Part 8. Sponsor's Contract, Statement, Contact
Information, Certification, and Signature
What Does Signing Form I-864 Require Me to do?
NOTE: Read the information on penalties in the Penalties
If an intending immigrant becomes a lawful permanent resident
section of the Form I-864 Instructions before completing this
in the United States based on a Form I-864 that you have
signed, then, until your obligations under Form I-864 terminate,
you must:
Sponsor's Contract
Provide the intending immigrant any support
necessary to maintain him or her at an income that is
Please note that, by signing this Form I-864, you agree to
at least 125 percent of the Federal Poverty
assume certain specific obligations under the Immigration and
Guidelines for his or her household size (100
Nationality Act (INA) and other Federal laws. The following
percent if you are the petitioning sponsor and are on
paragraphs describe those obligations. Please read the
active duty in the U.S. Armed Forces or U.S. Coast
following information carefully before you sign Form I-864. If
Guard, and the person is your husband, wife, or
you do not understand the obligations, you may wish to consult
unmarried child under 21 years of age); and
an attorney or accredited representative.
Form I-864 07/02/15 N
Page 7 of 12


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