Form i-134 Affidavit of Support for USCIS – Sample Pre-filled

Anil Gupta  5 Jan, 19      0  Forms

USCIS form I-134 Affidavit for support is required to file for officially sponsoring anyone for US visa or immigration.

Example: When you want to sponsor your parents, relatives or friends to USA on B2 tourist visitor Visa.

USCIS Form I-134 Sample – Affidavit for Support – Pre Filled

Assumptions:

  • This form is assumed to be filled by a person named Anil Gupta, working in Florida for TruVisa Services, on H1B visa, and giving this I-134 affidavit of support for his MOTHER to visit USA as a tourist. She will use it to apply B2 Visitor Visa.
  • Anil Gupta has a dependent wife (non-working) and a child who are both fully-dependent on him

You should change the values in the form as per your OWN situation.

How to write USCIS Affidavit of support form I-134

  1. Use BLACK ink pen only, when writing with pen.
  2. You, as a sponsor, have to Sign the form at Part 4, Item Number 6.a., Sponsor’s Signature.
  3. If there is no signature in Part 4, they will reject the form and return it to you.
  4. There is NO filing fees for form I-134. It is currently $0. You do not need to pay any money with this form to USCIS.
  5. If you are sponsoring more than one person (like your mother and father, both), you must submit a separate Form I-134 for each one of them.
  6. No notarization is needed . Signing Form I-134 is under penalty of perjury under U.S. law. For this reason, it is not necessary to sign Form I-134 before a notary, or to have your signature notarized after you sign it.
Sample Form I-134 Affidavit of Support
Sample Form I-134 Affidavit of Support

Form I-134 Affidavit for Support filling Instructions – Step by Step

Part 1 – Information about you

  1. a-c Fill your name details
  2. a-c If you have changed your name like after marriage, then specify your old name here.
  3. a-i Sponsor’s i.e. your own home address.
  4. Choose ‘Yes’ if your mailing and physical (where you live) are same. Else, choose ‘No’.
  5. a-h Fill your physical address here ONLY if you chose ‘No’ in Q 4.
  6. Your Date of Birth
  7. a-b Your birth City. Example: Delhi. Your country of Birth. Example: INDIA
  8. A (Alien) number. Leave Blank if you do not have it. Most people on H1B / L1 visa would not have it.
  9. SSN (Social Security Number) – Fill your SSN number. if you are working in USA on H1B or L1, you SHOULD have it.
  10. USCIS online account number. Leave Blank if you do not have it. Most people on H1B / L1 visa would not have it.
  11. a-e Your your citizenship status. Most people working in USA on H1B or L1 visa should select 11.e. I am a lawfully admitted nonimmigrant. Write your i-94 number in 11.e. too. All visa holders SHOULD have this i-94 number.
  12. Enter your age (in years) and date since you are residing in USA. It does not matter if you traveled outside USA couple of times. You should still write the date you first entered USA for living and working here. If there was a long break, like you went back to your country without knowing if you will ever come back, then you should not consider that date. Enter the most recent date when you entered USA for work/living purpose.

Part 2 – Information about Beneficiary

  1. a-c Name of the person you are sponsoring. Make sure it matches with their passport.
  2. Date of birth – Should match their passport AND birth certificate.
  3. Select Gender.
  4. A-Number. Leave Blank if the person you are sponsoring do not have it. Most people who do not live in USA will not have it. Example, If you are sponsoring your parent, relatives or friend for visitor visa, they will NOT have this number.
  5. Beneficiary’s country of citizenship. Example: India
  6. Choose Marital Status of the person you are sponsoring.
  7. Beneficiary’s relationship to you. Example, if the person is your MOTHER, write MOTHER.
  8. a-h Beneficiary’s address.
  9. a-c If Beneficiary is married (you would have selected it in Q 6 above), then write spouse name (Should match spouse’s passport, if any)
  10. Beneficiary, if married, his/her spouse’s date of birth (Should match spouse’s passport, if any).
  11. Beneficiary, if married, his/her spouse’s Gender.
  12. a-c Beneficiary’s child 1 name. In our example, the sponsor is the child. So, sponsor will fill his own name here. If Beneficiary has no child, then SKIP to Part 3.
  13. Child 1 date of birth (Should match child passport, if any)
  14. Child 1 gender.
  15. a-c Beneficiary’s child 2 name. In our example, the beneficiary has no second child. If Beneficiary has no child, then SKIP to Part 3.
  16. Child 2 date of birth (Should match child passport, if any)
  17. Child 2 gender.

If the beneficiary has more than 2 Children, then use Part 7 of the form to add their names, date of birth and Gender.

Part 3 – Other Information About the Sponsor

  1. a. Your designation at your current employer. For H1B and L1 visa workers, this should match your visa petition. Example, if your petition says ‘Computer programmer’, write the same here. 1.a.1 Your Employer name. If you are employed by a consultant company and currently deputed (physically working) at client location, you should still write your original employer’s name here i.e. consultant company. This should match your H1B or L1 visa too. 1.b. Choose this if you are self-employed
  2. a-h Write your employer’s address (the same employer that you have mentioned in Q1 above). For H1B or L1 workers, write your employer’s address that they have office at. If you are currently working at a client location, who’s address is different than your employer’s address, write the client’s location address.
  3. Write your annual salary.
  4. Current balance in your ALL bank accounts in USA. We recommend to have at-least a total of $10,000 but it is NOT a requirement. People have sponsored even with less money in their account. This amount helps USCIS take a decision, on whether, you can really support the person, that you say you can support.
  5. Value in USD for any other property that you own. Example, a car’s equity value, a home’s equity value, value of Gold that you own. Add them all and write it here.
  6. Market value of shares that you own. Example: You can include your 401(k) balance here.
  7. a-b Enter value of LIFE insurance, if you have any. Write 0.00, if you don’t have any.
  8. a-b If you own any house or real estate in USA, write its details here.
  9. a-d Your USA based real estate’s address, if you entered any value in Q 8 above.
  10. a-c Sponsor’s i.e. your own dependent’s name. We will call it dependent 1. Example, if your spouse or children are dependent on you, you have to write their details here.
  11. Relationship to the dependent 1. Example, if dependent 1 is your spouse, write SPOUSE here.
  12. Dependent 1 date of birth (Should match dependent 1’s passport).
  13. Choose ‘Wholly dependent’ if dependent 1 does not work.
  14. a-c dependent 2 details, if any.
  15. dependent 2 details, if any.
  16. dependent 2 details, if any.
  17. dependent 2 details, if any.
  18. a-c dependent 3 details, if any.
  19. dependent 3 details, if any.
  20. dependent 3 details, if any.
  21. dependent 3 details, if any.
  22. a-c If you ever given ‘I-134 Affidavit of support‘ to someone else before, you should enter the beneficiary’s name from that form here.
  23. If you entered a name in Q 22, enter the date at which you submitted form 1-134 for them.
  24. a-c Same as Q 22. Enter person 2, if you ever submitted I-134 for them.
  25. If you entered a name in Q 24, enter the date at which you submitted form 1-134 for them.
  26. a-c If you ever filed for someone’s USA Visa, enter their details. If you have just sponsored for your parent’s visa earlier, you do not need to write anything here. Visa filing is different than sponsoring.
  27. If you entered a name in Q 26, enter your relationship with the person.
  28. If you entered a name in Q 26, enter their date of birth.
  29. If you entered a name in Q 26, enter the date of filing their USA visa.
  30. a-c Same as Q 26 above.
  31. If you entered a name in Q 30, enter your relationship with the person.
  32. If you entered a name in Q 30, enter their date of birth.
  33. If you entered a name in Q 30, enter the date of filing their USA visa.
  34. a-c Same as Q 26 above.
  35. If you entered a name in Q 34, enter your relationship with the person.
  36. If you entered a name in Q 34, enter their date of birth.
  37. If you entered a name in Q 34, enter the date of filing their USA visa.
  38. Choose ‘Intend‘ if you are going to pay for the person’s travel/lodging etc, you are sponsoring. Else, choose ‘Do not intend’.

Part 4

1.a. Select this option if your can understand English. We are assuming you do.

  1. Leave it blank.
  2. Your Phone number.
  3. Your mobile number.
  4. Your personal email address.
  5. a. YOUR SIGNATURE. If you forget to sign, this form will be returned back to you.
  6. b. Date, when you are signing this form.

Part 5 – Interpreter’s information.

We assumed that you read and filled up this form on your own. If you used interpreter, enter his/her information in this section.

Part 6 – Prepare’s Information

We assumed that you read and filled up this form on your own. If someone else filled it up for you (liek an attorney), enter his/her information in this section.

Part 7 – Additional Information.

This section needs to be filled if there was NOT enough space available in form.

In our case, we selected ‘I INTEND’ in Q 38. Hence, we need to provide information about how we are going to support or pay the person we are sponsoring.

  1. a-c Write your name details.
  2. Your A number, if any. Most people on H1B or L1 visa would not have it.
  3. a. Page Number = 4 3.b Part Number = 3 3.c Item Number = 38 This number 38 refers to question 38. 3.d Add information about how and what you are going to pay the beneficiary. Example, in our case, the sponsor is inviting his mother to visit him in USA. So, this text is appropriate:
  4. All expenses including but not limited to their visa expenses, airline return tickets (cost to come to USA and back), US domestic travel, boarding, lodging, food, incidental expenses and visitor medical insurance.

  5. Fill additional information similar to Q 3, if any.
  6. Fill additional information similar to Q 3, if any
  7. Fill additional information similar to Q 3, if any
  8. Fill additional information similar to Q 3, if any

If you have reached this point, you are ALL set :slight_smile:

Form I-134 Notarize

There is no need to notarize the ‘Affidavit of support’.

If you do want to notarize or there is specific need to do it, you can get it done from your town library, your bank or a notary in your own employer’s office for FREE. USPS also provides notary services charging $5 per page.