Printable USCIS I-134 Template

The USCIS I-134 form, also known as the Affidavit of Support, is a document that helps demonstrate a sponsor's ability to financially support a non-citizen during their stay in the United States. This form is crucial for individuals seeking certain immigration benefits, as it assures the government that the applicant will not become a public charge. Understanding the requirements and implications of the I-134 is essential for both sponsors and applicants.

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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 by U.S. citizens and lawful permanent residents to demonstrate their financial ability to support a non-citizen applying for a visa or seeking to adjust their status. By completing the I-134, sponsors provide assurance that the immigrant will not become a public charge, meaning they will not rely on government assistance for their basic needs. The form requires detailed information about the sponsor's income, assets, and household size, ensuring that the U.S. government can assess the sponsor's financial stability. Additionally, the I-134 must be accompanied by supporting documentation, such as tax returns and pay stubs, to substantiate the claims made by the sponsor. Understanding the nuances of the I-134 is essential for both sponsors and applicants, as it lays the groundwork for a successful visa application and helps facilitate the immigrant's transition into American society.

Common mistakes

Incomplete Information: Many applicants fail to fill out all required sections of the I-134 form. Leaving any part blank can lead to delays or denials.
Incorrect Financial Information: Some individuals misstate their income or assets. It’s crucial to provide accurate financial details to demonstrate the ability to support the applicant.
Missing Supporting Documents: Often, applicants neglect to include necessary documentation, such as tax returns or bank statements. These documents are vital for verifying financial claims.
Failure to Sign: A common oversight is forgetting to sign the form. Without a signature, the application cannot be processed.
Incorrect Address: Providing an outdated or incorrect address can cause communication issues. Ensure that the address is current and clearly written.
Using Outdated Versions: Some people mistakenly use an older version of the form. Always check for the latest version on the USCIS website before submitting.
Not Reviewing Before Submission: Skipping a final review can lead to overlooked mistakes. Taking the time to double-check the form can prevent unnecessary complications.

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Key takeaways

The USCIS I-134 form, also known as the Affidavit of Support, plays a crucial role in the immigration process. Here are some key takeaways to keep in mind when filling out and using this form:

Purpose of the Form: The I-134 form is used to demonstrate that a visa applicant has sufficient financial support. This helps assure the U.S. government that the applicant will not become a public charge.
Eligibility Requirements: To fill out the I-134, the sponsor must be a U.S. citizen or lawful permanent resident, and they need to provide proof of their income and assets.
Completeness is Key: Ensure that all sections of the form are filled out completely and accurately. Missing information can lead to delays or denials in the application process.
Supporting Documents: Attach necessary documents, such as tax returns, pay stubs, and bank statements, to verify your financial capability. This documentation strengthens your affidavit.
Submission Process: After completing the form, submit it along with the visa application. Keep copies for your records, as you may need to refer to them later.

Understanding these key aspects of the I-134 form can significantly impact the success of the visa application process. Proper preparation and attention to detail are essential.

USCIS I-134 Example

	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

Understanding USCIS I-134

What is the USCIS I-134 form?

The USCIS I-134 form, also known as the Affidavit of Support, is a document used to demonstrate that a visa applicant has adequate financial support during their stay in the United States. It is typically required for non-immigrant visa applicants, such as those seeking tourist or student visas. The form helps ensure that the applicant will not become a public charge while in the U.S.

Who needs to submit the I-134 form?

The I-134 form is generally submitted by individuals who are sponsoring a foreign national for a non-immigrant visa. This includes:

Family members who wish to invite relatives to visit the U.S.
Friends or acquaintances who are supporting someone during their stay.
Organizations or institutions that are providing support for students or participants in exchange programs.

What information is required on the I-134 form?

The I-134 form requires various details about the sponsor and the applicant, including:

The sponsor's personal information, such as name, address, and date of birth.
Financial information, including income, assets, and employment details.
The relationship between the sponsor and the visa applicant.
Information about any dependents the sponsor may have.

Supporting documents, such as tax returns and bank statements, may also be required to substantiate the financial claims made on the form.

How do I submit the I-134 form?

The I-134 form can be submitted in two ways:

By mailing the completed form to the appropriate USCIS office, as specified in the visa application instructions.
By presenting it during the visa interview at the U.S. embassy or consulate.

It is important to ensure that the form is filled out completely and accurately to avoid delays in the visa application process.

How to Use USCIS I-134

After completing the USCIS I-134 form, you will need to gather the necessary supporting documents and submit everything according to the instructions provided by USCIS. Ensure that all information is accurate to avoid delays in processing.

Obtain the latest version of the USCIS I-134 form from the USCIS website.
Read the form instructions carefully before starting to fill it out.
Begin with your personal information. Provide your full name, address, and contact information in the designated sections.
Indicate your immigration status and provide details about your employment or financial situation.
List the name and information of the person you are sponsoring, including their relationship to you.
Fill in the financial information. Include your income, assets, and any other financial support you can provide.
Sign and date the form at the bottom. Ensure your signature matches the name provided at the top of the form.
Review the completed form for accuracy and completeness. Make any necessary corrections.
Gather all required supporting documents, such as proof of income and identification.
Submit the completed form and supporting documents to the appropriate USCIS address.