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Category: Business and Industry
Date Submitted: 01/22/2016 10:02 AM
Affidavit of Support Under Section 213A of the INA
Department of Homeland Security
U.S. Citizenship and Immigration Services
For
USCIS
Use
Only
Affidavit of Support Submitter
Petitioner
1st Joint Sponsor
2nd Joint Sponsor
Substitute Sponsor
5% Owner
OMB No. 1615-0075
Expires 07/31/2017
Section 213A Review
MEETS
requirements
USCIS
Form I-864
Number of Support Affidavits in File
DOES NOT MEET
requirements
Reviewed By:
Office:
Date (mm/dd/yyyy):
1
2
Remarks
â–ºSTART HERE - Type or print in black ink.
Part 2. Information About the Principal
Immigrant
Part 1. Basis For Filing Affidavit of Support
I,
am the sponsor submitting this affidavit of support because
(Select only one box):
1.a.
I am the petitioner. I filed or am filing for the
immigration of my relative.
1.b.
,
I filed an alien worker petition on behalf of the
intending immigrant, who is related to me as my
1.c.
I have an ownership interest of at least 5 percent in
which filed an alien worker petition on behalf of the
intending immigrant, who is related to me as my
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
Mailing Address
2.a. In Care Of Name
2.b. Street Number
and Name
2.c.
1.d.
I am the only joint sponsor.
1.e.
I am the
1.f.
The original petitioner is deceased. I am the
substitute sponsor. I am the intending immigrant's
first
second of two joint sponsors.
NOTE: If you select Item Number 1.a., 1.b., 1.c., 1.d., 1.e.,
or 1.f., you must include proof of your U.S. citizenship, U.S.
national status, or lawful permanent resident status.
Form I-864 07/02/15 N
Apt.
Ste.
Flr.
2.d. City or Town
2.e. State
2.f.
ZIP Code
2.g. Province
2.h. Postal Code
2.i.
Country
Page 1 of 12
Part 2. Information About the Principal
Immigrant (continued)
7.
Other Information
Family Member 2
3.
Country of Citizenship or...