Uscis I-864 Real Estate Consulting Agreement Page 8

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When Will These Obligations End?
Part 8. Sponsor's Contract, Statement, Contact
Information, Certification, and Signature
Your obligations under a Form I-864 that you signed will end if
the person who becomes a lawful permanent resident based on
(continued)
that affidavit:
B.
Notify U.S. Citizenship and Immigration Services
A.
Becomes a U.S. citizen;
(USCIS) of any change in your address, within 30
days of the change, by filing Form I-865.
B.
Has worked, or can receive credit for, 40 quarters of
coverage under the Social Security Act;
What Other Consequences Are There?
No longer has lawful permanent resident status and has
C.
departed the United States;
If an intending immigrant becomes a lawful permanent resident
in the United States based on a Form I-864 that you have
D.
Is subject to removal, but applies for and obtains, in
signed, then, until your obligations under Form I-864 terminate,
removal proceedings, a new grant of adjustment of status,
the U.S. Government may consider (deem) your income and
based on a new affidavit of support, if one is required; or
assets as available to that person, in determining whether he or
she is eligible for certain Federal means-tested public benefits
E.
Dies.
and also for state or local means-tested public benefits, if the
NOTE: Divorce does not terminate your obligations under
state or local government's rules provide for consideration
Form I-864.
(deeming) of your income and assets as available to the person.
Your obligations under a Form I-864 that you signed also end if
This provision does not apply to public benefits specified in
you die. Therefore, if you die, your estate is not required to
section 403(c) of the Welfare Reform Act such as emergency
take responsibility for the person's support after your death.
Medicaid, short-term, non-cash emergency relief; services
However, your estate may owe any support that you
provided under the National School Lunch and Child Nutrition
accumulated before you died.
Acts; immunizations and testing and treatment for
communicable diseases; and means-tested programs under the
Elementary and Secondary Education Act.
Sponsor's Statement
NOTE: Select the box for either Item Number 1.a. or 1.b.
What If I Do Not Fulfill My Obligations?
If applicable, select the box for Item Number 2.
If you do not provide sufficient support to the person who
becomes a lawful permanent resident based on a Form I-864
1.a.
I can read and understand English, and have read and
that you signed, that person may sue you for this support.
understand every question and instruction on this
affidavit, as well as my answer to every question.
If a Federal, state, local, or private agency provided any covered
1.b.
The interpreter named in Part 9. has also read to me
means-tested public benefit to the person who becomes a lawful
every question and instruction on this affidavit, as
permanent resident based on a Form I-864 that you signed, the
well as my answer to every question, in
agency may ask you to reimburse them for the amount of the
benefits they provided. If you do not make the reimbursement,
,
the agency may sue you for the amount that the agency believes
a language in which I am fluent. I understand every
you owe.
question and instruction on this affidavit as translated
If you are sued, and the court enters a judgment against you, the
to me by my interpreter, and have provided complete,
person or agency that sued you may use any legally permitted
true, and correct responses in the language indicated
procedures for enforcing or collecting the judgment. You may
above.
also be required to pay the costs of collection, including
attorney fees.
If you do not file a properly completed Form I-865 within 30
days of any change of address, USCIS may impose a civil fine
for your failing to do so.
Form I-864 07/02/15 N
Page 8 of 12

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