The Form I-864A, Affidavit of Support Under Section 213A of the INA, is a legally binding document used by a sponsor and a household member to jointly accept financial responsibility for an intending immigrant. This contract ensures the intending immigrant will not rely on public benefits, as the household member and sponsor commit to maintaining the immigrant at or above 125 percent of the Federal Poverty Guidelines. For those looking to support an immigrant's adjustment to life in the United States through financial means, completing Form I-864A is a critical step. Click the button below to fill out the form seamlessly.
The Form I-864A, "Contract Between Sponsor and Household Member," plays a crucial role in the United States immigration process, particularly in ensuring that intending immigrants have adequate financial support upon entering the country. This form is a legal document used by the U.S. Citizenship and Immigration Services (USCIS) and forms part of the broader Affidavit of Support framework. It binds a sponsor and a household member together in a mutual agreement to financially support an intending immigrant, thus establishing that the immigrant will not rely on public benefits after arriving in the U.S. The I-864A requires detailed information about the household member's relationship to the sponsor, their employment and income, federal income tax information, and assets. Additionally, both the sponsor and the household member make critical declarations regarding their financial capability and willingness to support the intending immigrant(s), underscored by the promise to maintain the immigrant at or above 125 percent of the Federal Poverty Guidelines. This form underscores the government's commitment to ensuring that immigrants have essential support without burdening the country's social services, embodying a critical aspect of U.S. immigration policy that meshes the private commitment of individuals with public interest.
Contract Between Sponsor and Household Member
USCIS
Department of Homeland Security
Form I-864A
OMB No. 1615-0075
U.S. Citizenship and Immigration Services
Expires 12/31/2023
For Government Use Only
This Form I-864A relates to a household member who:
IS the intending immigrant
IS NOT the
Reviewed By:
intending
Location:
Date (mm/dd/yyyy):
immigrant
To be completed by an
Select this box if
Attorney State Bar Number
Attorney or Accredited Representative
Form G-28 or
(if applicable)
USCIS Online Account Number (if any)
attorney or accredited
G-28I is attached.
representative (if any).
►START HERE - Type or print in black ink.
Part 1. Information About You (the Household Member)
Physical Address
4.a. Street Number
and Name
Full Name
1.a. Family Name
(Last Name)
1.b. Given Name
(First Name)
1.c. Middle Name
Mailing Address
(USPS ZIP Code Lookup)
2.a. In Care Of Name
4.b. Apt. 4.c. City or Town 4.d. State
4.f. Province
4.g. Postal Code
4.h. Country
Ste. Flr.
4.e. ZIP Code
2.b. Street Number
Other Information
2.c. Apt. 2.d. City or Town 2.e. State
2.g. Province
2.h. Postal Code
2.i. Country
2.f. ZIP Code
5.Date of Birth (mm/dd/yyyy)
Place of Birth 6.a. City or Town
6.b. State or Province
6.c. Country
3.Is your current mailing address the same as your physical
address?
Yes
No
If you answered "No" to Item Number 3., provide your physical address.
7.U.S. Social Security Number (if any)
►
8.USCIS Online Account Number (if any)
Form I-864A 12/08/21
Page 1 of 8
Part 2. Your (the Household Member's) Relationship to the Sponsor
Select Item Number 1.a., 1.b., or 1.c.
1.a.
I am the intending immigrant and also the sponsor's
spouse.
1.b.
I am the intending immigrant and also a member of
the sponsor's household.
1.c.
I am not the intending immigrant. I am the sponsor's
household member. I am related to the sponsor as
his/her:
Spouse
Son or Daughter (at least 18 years of age)
Parent
Brother or Sister
Other Dependent (Specify)
Part 3. Your (the Household Member's) Employment and Income
I am currently:
1. Employed as a/an
2.Name of Employer Number 1
3.Name of Employer Number 2 (if applicable)
4. Self employed as a/an
5. Retired from (Company Name)
Since (mm/dd/yyyy)
6. Unemployed since (mm/dd/yyyy)
7.My current individual annual income is:
$
Part 4. Your (the Household Member's) Federal Income Tax Information and Assets
1.a. Have you filed a Federal income tax return for each of the
three most recent tax years?
NOTE: You MUST attach a photocopy or transcript of
your Federal income tax return for only the most recent
tax year.
(Optional) I have attached photocopies or transcripts
of my Federal income tax returns for my second and
third most recent tax years.
My total income (adjusted gross income on IRS Form 1040EZ) as reported on my Federal income tax returns for the most recent three years was:
Tax Year
Total Income
2.a.
Most Recent
2.b.
2nd Most Recent
2.c.
3rd Most Recent
My assets (complete only if necessary).
3.a. Enter the balance of all cash, savings, and checking
accounts.$
3.b. Enter the net cash value of real-estate holdings. (Net value means assessed value minus mortgage debt.)
3.c. Enter the cash value of all stocks, bonds, certificates of deposit, and other assets not listed on Item Numbers 3.a.
or 3.b.
3.d. Add together Item Numbers 3.a., 3.b., and 3.c. and enter
the number here.
Part 5. Sponsor's Promise, Statement, Contact
Information, Declaration, Certification, and
Signature
NOTE: Read the Penalties section of the Form I-864A Instructions before completing this part.
I, THE SPONSOR,
,
(Print Name)
in consideration of the household member's promise to support the following intending immigrants and to be jointly and severally liable for any obligations I incur under the affidavit of support, promise to complete and file an affidavit of support on behalf of the following named intending immigrants.
(Indicate Number)
Page 2 of 8
Signature (continued)
Intending Immigrant Number 1
Name
2. Date of Birth (mm/dd/yyyy)
3.Alien Registration Number (A-Number, if any)
► A-
4.U.S. Social Security Number (if any)
5.USCIS Online Account Number (if any)
Intending Immigrant Number 2
6.a. Family Name
6.b. Given Name
6.c. Middle Name
7. Date of Birth (mm/dd/yyyy)
8.Alien Registration Number (A-Number, if any)
9.U.S. Social Security Number (if any)
10.USCIS Online Account Number (if any)
Intending Immigrant Number 3
11.a. Family Name
11.b. Given Name
11.c. Middle Name
12. Date of Birth (mm/dd/yyyy)
13.Alien Registration Number (A-Number, if any)
14.U.S. Social Security Number (if any)
15.USCIS Online Account Number (if any)
Intending Immigrant Number 4
16.a. Family Name
16.b. Given Name
16.c. Middle Name
17. Date of Birth (mm/dd/yyyy)
18.Alien Registration Number (A-Number, if any)
19.U.S. Social Security Number (if any)
20.USCIS Online Account Number (if any)
Intending Immigrant Number 5
21.a. Family Name
21.b. Given Name
21.c. Middle Name
22. Date of Birth (mm/dd/yyyy)
23.Alien Registration Number (A-Number, if any)
24.U.S. Social Security Number (if any)
25.USCIS Online Account Number (if any)
Sponsor's Statement
NOTE: Select the box for either Item Number 26.a. or 26.b. If applicable, select the box for Item Number 27.
26.a. I can read and understand English, and I have read and understand every question and instruction on this contract and my answer to every question.
Page 3 of 8
26.b. The interpreter named in Part 7. read to me every question and instruction on this contract and my answer to every question in
a language in which I am fluent, and I understood
everything.
27.
At my request, the preparer named in Part 8.,
prepared this contract for me based only upon information I provided or authorized.
Sponsor's Contact Information
28.Sponsor's Daytime Telephone Number
29.Sponsor's Mobile Telephone Number (if any)
30.Sponsor's Email Address (if any)
Sponsor's Declaration and Certification
Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that U.S. Citizenship and Immigration Services (USCIS) or the U.S. Department of State (DOS) may require that I submit original documents to USCIS or DOS at a later date. Furthermore, I authorize the release of any information from any and all of my records that USCIS or DOS may need to determine my eligibility for the immigration benefit that I seek.
I furthermore authorize release of information contained in this contract, in supporting documents, and in my USCIS or DOS records, to other entities and persons where necessary for the administration and enforcement of U.S. immigration law.
I certify, under penalty of perjury, that all of the information in my contract and any document submitted with it were provided or authorized by me, that I reviewed and understand all of the information contained in, and submitted with, my contract and that all of this information is complete, true, and correct.
Sponsor's Signature
31.a. Sponsor's Signature
31.b. Date of Signature (mm/dd/yyyy)
NOTE TO ALL SPONSORS: If you do not completely fill out this contract or fail to submit required documents listed in the Instructions, USCIS may deny your contract.
Part 6. Your (the Household Member's) Promise,
Statement, Contact Information, Declaration,
Certification, and Signature
I, THE HOUSEHOLD MEMBER,
in consideration of the sponsor's promise to complete and file an affidavit of support on behalf of the above named intending immigrants.
(Print number of intending immigrants noted in Part 5.
Sponsor's Promise, Statement, Contact Information, Declaration, Certification and Signature.)
A.Promise to provide any and all financial support necessary to assist the sponsor in maintaining the sponsored immigrants at or above the minimum income provided for in the Immigration and Naturalization Act (INA) section 213A(a)(1)(A) (not less than 125 percent of the Federal Poverty Guidelines) during the period in which the affidavit of support is enforceable;
B.Agree to be jointly and severally liable for payment of any and all obligations owed by the sponsor under the affidavit of support to the sponsored immigrants, to any agency of the Federal Government, to any agency of a state or local government, or to any other private entity that provides means-tested public benefits;
C.Certify under penalty under the laws of the United States that the Federal income tax returns submitted in support of the contract are true copies or unaltered tax transcripts filed with the Internal Revenue Service;
D.Consideration where the household member is also the sponsored immigrant: I understand that if I am the sponsored immigrant and a member of the sponsor's household that this promise relates only to my promise to be jointly and severally liable for any obligation owed by the sponsor under the affidavit of support to any of my dependents, to any agency of the Federal Government, to any agency of a state or local government, or to any other private entity that provides means-tested public benefits and to provide any and all financial support necessary to assist the sponsor in maintaining any of my dependents at or above the minimum income provided for in INA section 213A(a) (1)(A) (not less than 125 percent of the Federal Poverty Guideline) during the period which the affidavit of support is enforceable.
Page 4 of 8
Certification, and Signature (continued)
E.I understand that, if I am related to the sponsored immigrant or the sponsor by marriage, the termination of the marriage (by divorce, dissolution, annulment, or other legal process) will not relieve me of my obligations under this Form I-864A.
F.I authorize the Social Security Administration to release information about me in its records to the Department of State and U.S. Citizenship and Immigration Services (USCIS).
Your (the Household Member's) Statement
NOTE: Select the box for either Item Number 1.a. or 1.b. If applicable, select the box for Item Number 2.
I can read and understand English, and I have read
and understand every question and instruction on this
contract and my answer to every question.
The interpreter named in Part 7. read to me every
question and instruction on this contract and my
answer to every question in
2.
prepared this contract for me based only upon
information I provided or authorized.
Your (the Household Member's) Contact Information
3.Your (the Household Member's) Daytime Telephone Number
4.Your (the Household Member's) Mobile Telephone Number (if any)
5.Your (the Household Member's) Email Address (if any)
Your (the Household Member's) Declaration and Certification
Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS or DOS may require that I submit original documents to USCIS or DOS at a later date. Furthermore, I authorize the release of any information from any and all of my records that USCIS or DOS may need to determine my eligibility for the immigration benefit that I seek.
Your (the Household Member's) Signature
6.a. Your (the Household Member's) Printed Name
6.b. Your (the Household Member's) Signature
6.c. Date of Signature (mm/dd/yyyy)
NOTE TO ALL HOUSEHOLD MEMBERS: If you do not completely fill out this contract or fail to submit required documents listed in the Instructions, USCIS may deny your contract.
Part 7. Interpreter's Contact Information, Certification, and Signature
Provide the following information about the interpreter.
Interpreter's Full Name
1.a. Interpreter's Family Name (Last Name)
1.b. Interpreter's Given Name (First Name)
2.Interpreter's Business or Organization Name (if any)
Page 5 of 8
Part 7. Interpreter's Contact Information, Certification, and Signature (continued)
Interpreter's Mailing Address
Part 8. Contact Information, Declaration, and Signature of the Person Preparing this Contract, if Other Than the Sponsor or Household Member
Provide the following information about the preparer.
3.a. Street Number
3.b. Apt. 3.c. City or Town 3.d. State
3.f. Province
3.g. Postal Code
3.h. Country
3.e. ZIP Code
Preparer's Full Name
1.a. Preparer's Family Name (Last Name)
1.b. Preparer's Given Name (First Name)
2.Preparer's Business or Organization Name (if any)
Preparer's Mailing Address
Interpreter's Contact Information
4.Interpreter's Daytime Telephone Number
5.Interpreter's Mobile Telephone Number (if any)
6.Interpreter's Email Address (if any)
Interpreter's Certification
I certify, under penalty of perjury, that:
I am fluent in English and
which is the same language specified in Part 5., Item
Number 26.b. or Part 6., Item Number 1.b., and I have read
to this sponsor or household member in the identified language
every question and instruction on this contract and his or her
answer to every question. The sponsor or household member
informed me that he or she understands every instruction,
question, and answer on the contract, including the Sponsor's
or Household Member's Declaration and Certification, and
has verified the accuracy of every answer.
Interpreter's Signature
7.a. Interpreter's Signature
7.b. Date of Signature (mm/dd/yyyy)
Preparer's Contact Information
4.Preparer's Daytime Telephone Number
5.Preparer's Mobile Telephone Number (if any)
6.Preparer's Email Address (if any)
Page 6 of 8
(continued)
Preparer's Statement
7.a.
7.b.
I am not an attorney or accredited representative but have prepared this contract on behalf of the sponsor and household member and with the sponsor's or household member's consent.
I am an attorney or accredited representative and my representation of the sponsor and household member in this case extends does not extend beyond
the preparation of this contract.
NOTE: If you are an attorney or accredited representative, you may be obliged to submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, or G-28I, Notice of Entry of Appearance as Attorney In Matters Outside the Geographical Confines of the United States, with this contract.
Preparer's Certification
By my signature, I certify, under penalty of perjury, that I prepared this contract at the request of the sponsor and household member. The sponsor and household member then reviewed this completed contract and informed me that he or she understands all of the information contained in, and submitted with, his or her contract, including the Sponsor's or Household Member's Declaration and Certification, and that all of this information is complete, true, and correct. I completed this contract based only on information that the sponsor and household member provided to me or authorized me to obtain or use.
Preparer's Signature
8.a. Preparer's Signature
8.b. Date of Signature (mm/dd/yyyy)
Page 7 of 8
Part 9. Additional Information
If you need extra space to provide any additional information within this contract, use the space below. If you need more space than what is provided, you may make copies of this page to complete and file with this contract or attach a separate sheet of paper. Type or print your name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet.
1.a. Family Name (Last Name)
1.b. Given Name (First Name)
2.A-Number (if any)
3.a. Page Number 3.b. Part Number 3.c. Item Number
3.d.
4.a. Page Number 4.b. Part Number 4.c. Item Number
4.d.
5.a. Page Number 5.b. Part Number 5.c. Item Number
5.d.
6.a. Page Number 6.b. Part Number 6.c. Item Number
6.d.
7.a. Page Number 7.b. Part Number 7.c. Item Number
7.d.
Page 8 of 8
Filling out the I-864A Affidavit of Support form is a critical step in the process of sponsoring a relative for U.S. immigration. This form serves as a contract between a sponsor and a household member, outlining the financial responsibilities to support the intending immigrant. It ensures that the immigrant will not become a public charge while in the United States. Following precise steps is necessary to complete the form accurately to prevent any delays in the immigration process.
Once submitted, keep a copy of the form and all documents for your records. Monitor your mail and email (if applicable) for any correspondence from USCIS and respond to any requests for additional information in a timely manner.
What is Form I-864A?
Form I-864A, Contract Between Sponsor and Household Member, is a legal document used in the immigration process. It allows a household member to agree to support an immigrant, along with the sponsor, ensuring the immigrant has enough financial support to avoid becoming reliant on public benefits. This contract is binding to both the sponsor and the household member, making them jointly responsible for the financial obligations.
Who needs to complete Form I-864A?
Form I-864A must be completed by household members who are combining their income with the sponsor’s income to meet the income requirement for sponsoring the intending immigrant. This usually includes relatives or dependants living in the same household as the sponsor who are at least 18 years of age.
How is a "household member" defined for the purposes of Form I-864A?
A "househmold member" refers to someone who is living in the sponsor's same residence and is related to the sponsor by birth, marriage, or adoption. This includes the sponsor's spouse, children, or any other dependants who will contribute their income to support the intending immigrant.
What is the difference between Form I-864 and Form I-864A?
Form I-864, Affidavit of Support, is completed by the sponsor to prove they can support the immigrant financially. Form I-864A, on the other hand, is an agreement between a sponsor and a household member who wants to combine their financial resources with the sponsor to meet the income requirements. Form I-864A serves to make the household member equally liable for the financial support of the sponsored immigrant.
What information and documents are required for Form I-864A?
To complete Form I-864A, you will need: the household member's personal information, the household member's relationship to the sponsor, information about the household member's employment and income, and the household member's Federal income tax information. You must also attach a photocopy or transcript of your most recent Federal income tax return, and optionally, your returns from the two years before that.
What happens if the marriage between the sponsor and the household member ends?
If the marriage between the sponsor and the household member, who has signed Form I-864A, ends, it does not relieve the household member of their legal obligations under the contract. This means that even after a divorce or legal separation, the household member remains responsible for any financial obligations incurred under the affidavit of support.
How long is Form I-864A enforceable?
Form I-864A is enforceable until the sponsored immigrant becomes a U.S. citizen, has worked 40 qualifying quarters credited toward Social Security, leaves the United States permanently, or dies. It is important to understand that divorce or changes in relationship do not terminate the agreement.
Filling out the Form I-864A, the Affidavit of Support Contract Between Sponsor and Household Member, is a critical step in the process of sponsoring an immigrant for U.S. residency. However, several common mistakes can lead to delays or denial of the application. Understanding these pitfalls can help ensure the process goes smoothly.
To avoid these errors, individuals completing the Form I-864A should carefully review each section, double-check all entered information against supporting documents, and ensure that all necessary attachments are included before submission. Utilizing the instructions provided by USCIS can also help clarify requirements and reduce the likelihood of mistakes. Diligence and attention to detail at this stage can significantly smooth the path for the intending immigrant’s transition to life in the United States.
When someone is involved in the immigration process in the United States, the Form I-864A, Affidavit of Support Under Section 213A of the INA, is often a crucial document. This form serves as a contract between a sponsor and a household member to financially support an intending immigrant. However, this form does not stand alone in the immigration process. Several other forms and documents are commonly used alongside Form I-864A to ensure a comprehensive and successful application.
Each document plays a role in the intricate process of immigration, from proving familial relationships to ensuring that intending immigrants have adequate financial support once they arrive in the United States. Applicants and sponsors must pay careful attention to the specific requirements of each form and document to ensure their application packet is complete and accurate. This meticulous preparation can lead to a smoother immigration process, paving the way for a new beginning in the United States.
The Form I-864, Affidavit of Support Under Section 213A of the Act, shares similarities with the I-864A in principle and function. Both are legal contracts used in the immigration process to demonstrate that an immigrant will have adequate financial support in the United States and is not likely to become a public charge. The main difference lies in the participants: the I-864 involves a sponsor supporting the immigrant directly, while the I-864A allows a household member to contribute to this financial support alongside the sponsor.
The Form I-134, Affidavit of Support, also parallels the I-864A in its purpose of providing a financial guarantee for immigrants. However, the I-134 is typically used for non-immigrant visas, such as for visitors or fiancés, to assure the U.S. government that the visa applicant has adequate financial support during their stay and will not rely on public resources. Despite these differences, both forms serve to provide a written promise of financial responsibility for an incoming individual to the United States.
Another related document is the Form I-765, Application for Employment Authorization. While not a support affidavit, it indirectly relates to the financial independence and support mechanisms within immigration law. By obtaining employment authorization, the immigrant can financially support themselves, reducing or eliminating the need for a sponsor or household member's financial undertaking as outlined in the I-864 or I-864A forms. The I-765 is vital for the self-reliance of many immigrants, aligning with the objectives of sponsorship forms to prevent public charge.
Lastly, the Form DS-260, Immigrant Visa Electronic Application, is indirectly related to the I-864A. Part of the consulate processing for acquiring an immigrant visa, it requires applicants to disclose financial information that demonstrates they will not become a public charge. While the DS-260 is more comprehensive and covers various aspects beyond financial support, the necessity to prove financial stability or sponsorship is a common thread it shares with the I-864A, highlighting the broader requirements of the U.S. immigration process concerning financial assurances.
When completing the I-864A Affidavit of Support form, there are certain practices you should follow to ensure an accurate and successful submission. Below are recommendations to guide you through the process:
In contrast, several actions should be avoided to prevent delays or denial of the form:
There are several misconceptions surrounding the I-864A Affidavit of Support form, which is essential for understanding to ensure smooth immigration proceedings. By debunking these myths, individuals can approach this form with clearer expectations and better preparedness. Here is a list of the most common misunderstandings:
Clearing up these misconceptions about the I-864A form is crucial for both sponsors and household members. It ensures all parties understand their responsibilities and the importance of this document in the immigration process.
Completing and using the Form I-864A, Affidavit of Support, requires careful attention to detail and understanding of its purpose. Here are key takeaways to guide you through this process:
It is critical for both parties to understand their responsibilities under this agreement to prevent legal complications and ensure the successful immigration of the intending immigrant.
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