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Blank USCIS I-134 Form

The USCIS I-134 form, also known as the Affidavit of Support, is a document used by individuals in the United States to demonstrate their financial ability to support a non-citizen applying for a visa. This form plays a crucial role in the immigration process, ensuring that applicants have adequate financial backing during their stay. To learn more about filling out the form, click the button below.

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Table of Contents

The USCIS I-134 form, also known as the Affidavit of Support, plays a crucial role in the immigration process for individuals seeking to enter the United States. This form is primarily used to demonstrate that a visa applicant has adequate financial support and will not become a public charge upon arrival. It requires the sponsor, typically a U.S. citizen or lawful permanent resident, to provide detailed information about their income, assets, and employment status. The sponsor must also provide evidence of their ability to support the applicant financially, which includes submitting tax returns and pay stubs. Completing the I-134 form accurately is essential, as it helps immigration officials assess the applicant's financial viability and the sponsor's commitment to providing support. Additionally, the form serves as a legal contract, binding the sponsor to provide assistance for the duration of the applicant's stay in the U.S. Understanding the nuances of the I-134 form can significantly impact the outcome of an immigration application, making it a vital component for those navigating the immigration system.

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Dos and Don'ts

When filling out the USCIS I-134 form, it's important to follow certain guidelines to ensure your application is processed smoothly. Below is a list of things you should and shouldn't do.

Do read the instructions carefully before starting the form.
Do provide accurate and truthful information throughout the application.
Do use black ink and write legibly to avoid any confusion.
Do check for any required signatures and dates before submission.
Do keep a copy of the completed form for your records.

Don't leave any required fields blank; fill in all necessary information.
Don't use abbreviations unless specified in the instructions.
Don't submit the form without reviewing it for errors.
Don't forget to include any supporting documents that may be required.

USCIS I-134 Sample

	Affidavit of Support	USCIS
	Department of Homeland Security	Form I-134
	Department of Homeland Security	OMB No. 1615-0014
	U.S. Citizenship and Immigration Services	Expires 02/28/2021

►START HERE - Type or print in black ink.

Part 1. Information About You (the Sponsor)

Your Full Name

1.a. Family Name

(Last Name)

1.b. Given Name

(First Name)

1.c. Middle Name

Other Names Used

List all other names you have ever used, including aliases, maiden name, and nicknames. If you need extra space to complete this section, use the space provided in Part 7.

Additional Information.

2.a. Family Name

(Last Name)

2.b. Given Name

(First Name)

2.c. Middle Name

Sponsor's Mailing Address	(USPS ZIP Code Lookup)

3.a. In Care Of Name

3.b. Street Number

and Name

3.c. Apt. Ste. Flr.

3.d. City or Town

3.e. State		3.f. ZIP Code

3.g. Province

3.h. Postal Code

3.i. Country

4.Are your mailing address and physical address the same?

Yes No

If you answered "No" to Item Number 4., provide your physical address in Item Numbers 5.a. - 5.h.

Sponsor's Physical Address

5.a. Street Number

and Name

5.b. Apt. Ste. Flr.

5.c. City or Town

5.d. State		5.e. ZIP Code

5.f. Province

5.g. Postal Code

5.h. Country

Other Information

6.Date of Birth (mm/dd/yyyy)

7.a. Town or City of Birth

7.b. Country of Birth

8.Alien Registration Number (A-Number) (if any)

► A-

9.U.S. Social Security Number (if any)

►

10.USCIS Online Account Number (if any)

►

Citizenship or Residency or Status

If you are not a U.S. citizen based on your birth in the United States, or a non-citizen U.S. national based on your birth in American Samoa (including Swains Island), answer the following as appropriate:

11.a. I am a U.S. citizen through naturalization. My Certificate of Naturalization number is

11.b. I am a U.S. citizen through parent(s) or marriage. My Certificate of Citizenship number is

Form I-134 02/13/19

Page 1 of 8

Part 1. Information About You (the Sponsor)

(continued)

11.c.

I derived my U.S. citizenship by another method.

(Provide an explain in Part 7. Additional

Information.)

11.d.

I am a lawful permanent resident of the

United States. My A-Number is

► A-

11.e.

I am a lawfully admitted nonimmigrant. My

Form I-94, Arrival-Departure Record Number is

►

12.

I am

years of age and have resided in the United

States since (Date) (mm/dd/yyyy)

Part 2. Information About the Beneficiary

This affidavit is executed on behalf of the following person:

1.a. Family Name

(Last Name)

1.b. Given Name

(First Name)

1.c. Middle Name

2.Date of Birth (mm/dd/yyyy)

3. Gender Male Female

4.A-Number (if any)

► A-

5.Country of Citizenship or Nationality

6.Marital Status

Single or Single, Never Married

Married

Divorced

Widowed

Legally Separated

Marriage Annulled

Other

7.Relationship to Sponsor

Beneficiary's Physical Address

8.a.	Street Number
	and Name
	Apt.
8.b.	Apt.	Ste.		Flr.
8.c.	City or Town




8.d.	State		8.e.	ZIP Code

8.f.	Province
8.f.	Province
8.g.	Postal Code


8.h.	Country
8.h.	Country

Beneficiary's Spouse (accompanying or following to join beneficiary)

9.a. Family Name

(Last Name)

9.b. Given Name

(First Name)

9.c. Middle Name

10.Date of Birth (mm/dd/yyyy)

11.Gender Male Female

Beneficiary's Children

Child 1

12.a. Family Name

(Last Name)

12.b. Given Name

(First Name)

12.c. Middle Name

13.Date of Birth (mm/dd/yyyy)

14.Gender Male Female

Child 2

15.a. Family Name

(Last Name)

15.b. Given Name

(First Name)

15.c. Middle Name

16.Date of Birth (mm/dd/yyyy)

17. Gender Male Female

If you need additional space to complete this section, use the

space provided in Part 7. Additional Information.

Form I-134 02/13/19

Page 2 of 8

Part 3. Other Information About the Sponsor

7.a. I have life insurance in the sum of $

Employment Information

I am currently:

1.a. Employed as a/an

1.a.1. Name of Employer (if applicable)

1.b.	Self employed as a/an

Current Employer Address (if employed)

2.a. Street Number

and Name

2.b. Apt. Ste. Flr.

2.c. City or Town

2.d. State		2.e. ZIP Code

2.f. Province

2.g. Postal Code

2.h. Country

Income and Asset Information

3. My annual income is

(If self-employed, I have attached a copy of my last income tax return or report of commercial rating concern which I certify to be true and correct to the best of my knowledge and belief. See Instructions for nature of evidence of net worth to be submitted.)

4.Balance of all my savings and checking accounts in United States-based financial institutions

5.Value of my other personal property

6.Market value of my stocks and bonds

I have listed my stocks and bonds in Part 7. Additional Information (or attached a list of them), which I certify to be true and correct to the best of my knowledge and belief.

7.b. With a cash surrender value of

Real Estate Information

8.a. I own real estate valued at

8.b. I have mortgages or other debts amounting to

My real estate is located at:

9.a. Street Number

and Name

9.b. Apt. Ste. Flr.

9.c. City or Town

9.d. State		9.e. ZIP Code

Dependents' Information

The following persons are dependent upon me for support. If you need extra space to complete this section, use the space provided in Part 7. Additional Information.

10.a. Family Name

(Last Name)

10.b. Given Name

(First Name)

10.c. Middle Name

11.Relationship to Me:

12.Date of Birth (mm/dd/yyyy)

13.This person is:

Wholly Dependent On Me For Support

Partially Dependent On Me For Support

14.a. Family Name

(Last Name)

14.b. Given Name

(First Name)

14.c. Middle Name

15.Relationship to Me:

16.Date of Birth (mm/dd/yyyy)

Form I-134 02/13/19

Page 3 of 8

Part 3. Other Information About the Sponsor

(continued)

17.This person is:

Wholly Dependent On Me For Support

Partially Dependent On Me For Support

18.a. Family Name

(Last Name)

18.b. Given Name

(First Name)

18.c. Middle Name

19.Relationship to Me:

20.Date of Birth (mm/dd/yyyy)

21.This person is:

Wholly Dependent On Me For Support

Partially Dependent On Me For Support

I have previously submitted affidavit(s) of support for the following person(s). (If none, write "None" in the space for name below.)

22.a. Family Name

(Last Name)

22.b. Given Name

(First Name)

22.c. Middle Name

23.Date Submitted (mm/dd/yyyy)

24.a. Family Name

(Last Name)

24.b. Given Name

(First Name)

24.c. Middle Name

25.Date Submitted (mm/dd/yyyy)

I have submitted a visa petition(s) to U.S. Citizenship and Immigration Services on behalf of the following persons. (If none, write “None” in the space for name below.)

26.a. Family Name

(Last Name)

26.b. Given Name

(First Name)

26.c. Middle Name

27.Relationship to Me:

28. Date of Birth (mm/dd/yyyy)

29. Date of Filing (mm/dd/yyyy)

30.a. Family Name

(Last Name)

30.b. Given Name

(First Name)

30.c. Middle Name

31.Relationship to Me:

32. Date of Birth (mm/dd/yyyy)

33. Date of Filing (mm/dd/yyyy)

34.a. Family Name

(Last Name)

34.b. Given Name

(First Name)

34.c. Middle Name

35.Relationship to Me:

36. Date of Birth (mm/dd/yyyy)

37. Date of Filing (mm/dd/yyyy)

38.I intend do not intend to make specific contributions to the support of the person(s) named in Part 2.

(If you select "intend," indicate the exact nature and duration of the contributions you intend to make in Part 7. Additional Information. For example, if you intend to furnish room and board, state for how long and, if money, state the amount in U.S. dollars and whether it is to be given in a lump sum, weekly or monthly, and for how long.)

Form I-134 02/13/19

Page 4 of 8

Part 4. Sponsor's Statement, Contact Information, Certification, and Signature

NOTE: Read the Penalties section of the Form I-134 Instructions before completing this part.

Sponsor's Statement

NOTE: Select the box for either Item Number 1.a. or 1.b. If applicable, select the box for Item Number 2.

1.a.	I can read and understand English, and I have read and
	understand every question and instruction on this
	affidavit and my answer to every question.
1.b.	The interpreter named in Part 5. read to me every
	question and instruction on this affidavit and my
	answer to every question in
		,

	a language in which I am fluent and I understood
	everything.
2.	At my request, the preparer named in Part 6.,

		,

prepared this affidavit for me based only upon information I provided or authorized.

Sponsor's Contact Information

3.Sponsor's Daytime Telephone Number

4.Sponsor's Mobile Telephone Number (if any)

5.Sponsor's Email Address (if any)

Sponsor's Certification

Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS or the Department of State may require that I submit original documents to USCIS or the Department of State at a later date. Furthermore, I authorize the release of any information from any of my records that USCIS or the Department of State may need to determine my eligibility for the immigration benefit I seek.

I further authorize release of information contained in this affidavit, in supporting documents, and in my USCIS or the Department of State records to other entities and persons where necessary for the administration and enforcement of U.S. immigration laws.

I understand that USCIS may require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or signature) and, at that time, if I am required to provide biometrics, I will be required to sign an oath reaffirming that:

1)I reviewed and provided or authorized all of the information in my affidavit;

2)I understood all of the information contained in, and submitted with, my affidavit; and

3)All of this information was complete, true, and correct at the time of filing.

I certify, under penalty of perjury, that I provided or authorized all of the information in my affidavit, I understand all of the information contained in, and submitted with, my affidavit, and that all of this information is complete, true, and correct.

That this affidavit is made by me to assure the U.S. Government that the person named in Part 2. will not become a public charge in the United States.

That I am willing and able to receive, maintain, and support the person named in Part 2. I am ready and willing to deposit a bond, if necessary, to guarantee that such persons will not become a public charge during his or her stay in the United States, or to guarantee that the above named persons will maintain his or her nonimmigrant status, if admitted temporarily, and will depart prior to the expiration of his or her authorized stay in the United States.

That I understand that Form I-134 is an "undertaking" under section 213 of the Immigration and Nationality Act, and I may be sued if the persons named in Part 2. become a public charge after admission to the United States.

That I understand that Form I-134 may be made available to any Federal, State, or local agency that may receive an application from the persons named in Part 2. for Food Stamps, Supplemental Security Income, or Temporary Assistance to Needy Families.

That I understand that if the person named in Part 2. does apply for Food Stamps, Supplemental Security Income, or Temporary Assistance for Needy Families, my own income and assets may be considered in deciding the person's application. How long my income and assets may be attributed to the persons named in Part 2. is determined under the statutes and rules governing each specific program.

I acknowledge that I have read the section entitled Sponsor and Beneficiary Liability in the Instructions for this affidavit, and am aware of my responsibilities as a sponsor under the Social Security Act, as amended, and the Food Stamp Act, as amended.

Sponsor's Signature

6.a. Sponsor's Signature

6.b. Date of Signature (mm/dd/yyyy)

Form I-134 02/13/19

Page 5 of 8

NOTE TO ALL SPONSORS: If you do not completely fill out this affidavit or fail to submit required documents listed in the Instructions, USCIS or the Department of State may deny your affidavit.

Part 5. 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)

Interpreter's Mailing Address

3.a. Street Number

and Name

3.b. Apt. Ste. Flr.

3.c. City or Town

3.d. State		3.e. ZIP Code

3.f. Province

3.g. Postal Code

3.h. Country

Interpreter's Certification

I certify, under penalty of perjury, that:
I am fluent in English and	,

which is the same language provided in Part 4., Item Number 1.b., and I have read to this sponsor in the identified language every question and instruction on this affidavit and his or her answer to every question. The sponsor informed me that he or she understands every instruction, question, and answer on the affidavit, including the Sponsor's 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)

Part 6. Contact Information, Statement, Declaration, and Signature of the Person Preparing this Affidavit, if Other Than the Sponsor

Provide the following information about the preparer.

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)

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)

Preparer's Mailing Address

3.a. Street Number

and Name

3.b. Apt. Ste. Flr.

3.c. City or Town

3.d. State		3.e. ZIP Code

3.f. Province

3.g. Postal Code

3.h. Country

Form I-134 02/13/19

Page 6 of 8

Part 6. Contact Information, Statement, Declaration, and Signature of the Person Preparing this Affidavit, if Other Than the

Sponsor (continued)

Preparer's Contact Information

4.Preparer's Daytime Telephone Number

5.Preparer's Fax Number

6.Preparer's Email Address (if any)

Preparer's Statement

7.a.

I am not an attorney or accredited representative but have prepared this affidavit on behalf of the sponsor and with the sponsor's consent.

7.b. I am an attorney or accredited representative and my representation of the sponsor in this case

extends does not extend beyond the preparation of this affidavit.

NOTE: If you are an attorney or accredited representative whose representation extends beyond preparation of this affidavit, you may be obliged to submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, with this application.

Preparer's Certification

By my signature, I certify, under penalty of perjury, that I prepared this affidavit at the request of the sponsor. The sponsor then reviewed this completed affidavit and informed me that he or she understands all of the information contained in, and submitted with, his or her affidavit, including the Sponsor's Certification, and that all of this information is complete, true, and correct. I completed this affidavit based only on information that the sponsor 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)

Form I-134 02/13/19

Page 7 of 8

Part 7. Additional Information

If you need extra space to provide any additional information within this affidavit, 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 affidavit or attach a separate sheet of paper. Type or print your name and A-Number (if any) at the top of each sheet; type or print the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet.

5.a. Page Number 5.b. Part Number 5.c. Item Number

5.d.

Your Full Name

1.a.

Family Name

(Last Name)

1.b.

Given Name

(First Name)

1.c.

Middle Name

A-Number (if any)

6.a. Page Number 6.b. Part Number 6.c. Item Number

► A-

3.a.

Page Number 3.b. Part Number

3.c. Item Number

6.d.

3.d.

		7.a. Page Number 7.b. Part Number 7.c. Item Number

4.a. Page Number 4.b. Part Number	4.c. Item Number	7.d.
4.a. Page Number 4.b. Part Number	4.c. Item Number

4.d.

Form I-134 02/13/19

Page 8 of 8

Listed Questions and Answers

What is the USCIS I-134 form?
The USCIS I-134 form, also known as the Affidavit of Support, is a document used by individuals in the United States to demonstrate their ability to financially support a non-citizen who is seeking to enter or remain in the U.S. This form is often required for visa applications, particularly for family members or individuals applying for certain types of humanitarian relief.
Who needs to file the I-134 form?
The I-134 form must be filed by a U.S. citizen or a lawful permanent resident who wishes to sponsor a non-citizen. This sponsor must show that they have adequate income or financial resources to support the non-citizen during their stay in the U.S. The form is typically used in situations like family reunification or for individuals seeking asylum.
What information is required on the I-134 form?
When completing the I-134 form, the sponsor must provide personal information, including:
- Name and address
- Employment details
- Income and financial resources
- Information about the non-citizen being sponsored
Additionally, the sponsor may need to provide supporting documents, such as tax returns, pay stubs, or bank statements to prove their financial capability.
How is the I-134 form submitted?
The completed I-134 form can be submitted to the U.S. Citizenship and Immigration Services (USCIS) as part of a visa application process. It may also be required to be presented at a consulate or embassy during an interview. Ensure that all required documentation accompanies the form to avoid delays.
Is there a filing fee for the I-134 form?
There is no filing fee associated with the I-134 form itself. However, other fees may be applicable depending on the specific visa application process in which the form is used. Always check the latest guidelines from USCIS for any updates on fees.
What happens after submitting the I-134 form?
Once the I-134 form is submitted, the sponsoring individual may be contacted for additional information or documentation. The consular officer or immigration official will review the form and the supporting documents during the visa application process. If everything is satisfactory, the non-citizen may receive their visa.
Can the I-134 form be revoked?
Yes, the I-134 form can be revoked. If the sponsor's circumstances change, such as a significant drop in income or a change in residency status, they should notify the relevant authorities. Revocation can impact the non-citizen's visa status, so it is important to communicate any changes promptly.
How long is the I-134 form valid?
The I-134 form does not have a specific expiration date. However, it should be submitted in conjunction with a visa application and must reflect the sponsor's current financial situation. If there are significant changes in the sponsor's circumstances, it may be necessary to submit a new form.
Where can I find more information about the I-134 form?
For more detailed information about the I-134 form, including instructions for completion and submission, visit the official USCIS website. This resource provides up-to-date guidance and answers to frequently asked questions regarding immigration processes.

Form Overview

Fact Name	Description
Purpose	The I-134 form is used to demonstrate that an individual has adequate financial support while applying for a visa or green card.
Who Uses It?	It is typically completed by a sponsor, who may be a family member or friend of the applicant, to affirm their ability to support the applicant financially.
Submission Process	The completed I-134 form must be submitted to the U.S. Citizenship and Immigration Services (USCIS) along with the visa application.
Supporting Documents	Along with the I-134 form, sponsors must provide evidence of their income, such as tax returns, pay stubs, or bank statements.
Eligibility Criteria	To be a sponsor, one must be a U.S. citizen or a lawful permanent resident and meet certain income requirements.
Legal Obligations	By signing the I-134 form, the sponsor agrees to support the applicant financially and may be legally responsible for any public benefits the applicant receives.
Validity Period	The I-134 form does not have a specific expiration date, but it should be current and reflect the sponsor's financial situation at the time of submission.
State-Specific Forms	Some states may have additional requirements or forms related to financial support, but the I-134 itself is a federal form governed by U.S. immigration law.
Common Mistakes	Common errors include incomplete information, outdated financial documents, and failing to sign the form, which can delay the application process.