Form I-363 Request to Enforce Affidavit of Financial Support and In

OMB No. 1615-0022;Exp. 12/31/2014

Form I-363, Request to Enforce Affidavit of
Financial Support and Intent to Petition for Legal
Custody for P. L. 97-359 Amerasian

Department of Homeland Security
U.S. Citizenship and Immigration Services

Type or print in black ink. - See instructions on reverse side.
1. Beneficiary's Family Name (Capital Letters)

First Name

2. Alien Registration Number
A(State)
(Zip Code)

Middle Name

3. Mailing Address in U.S.
(Number, Street, Apt.)
C/O:
4. Employer or School (Name and Address

(City)

5. Country of Citizenship

6. Date of Birth (mm/dd/yyyy) 7. Place of Birth (City or Town) (Province or State) (Country) 8. Applicant's Phone Number
(Include Area Code)

9. Initially Admitted to U.S. at (City and State)

10. Beneficiary's Relationship to Sponsor

11. Destination in U.S. at Time of Initial Admission

12. Beneficiary's file is at USCIS office in (City and State)

13. Sponsor's Family Name (Capital Letters)

First Name

Middle Name

U.S. Citizen
Lawful Permanent Resident

14. Sponsor's Present Address
15. Sponsor's Employer

Sponsor's Phone Number
(Include Area Code)

16. Does the beneficiary live with the sponsor?

17. If not, with whom does the beneficiary live?
Yes
No
18. How is the beneficiary supported? (Sponsor? Other Sources?)
How long has the beneficiary been supported by the sponsor?
19. Is the beneficiary in the legal custody of the sponsor?
20. Has the sponsor stopped all support?
21. Has the sponsor give any reason for
withdrawal of support?

Yes
No
Yes
No
Yes
No

(Explain)
Since when? (mm/dd/yyyy)
If "Yes," describe the circumstances under which the
sponsor ceased his or her support.

NOTE: Attach a copy of Form I-361, Affidavit of Financial Support and Intent to Petition for Legal Custody for P. L. 97-359
Amerasian, if available.
22. Relationship of Applicant
Self

Representative of the Agency Having Legal Custody of the Beneficiary

Individual Having Legal Custody of the Beneficiary

Guardian Ad Litem

23. Signature and Date of Person Preparing Form, If Other Than Applicant

24. Signature of Applicant and Date

Do Not Write Below This Line.

ACTION BLOCK (For use by USCIS officer) This applicant was interviewed by me
on

(Date)

Remarks:

at
Investigation Completed on
Investigation Not Necessary

by phone

(Place)
(Date)

(Signature and Title)
Recommendation Forwarded to U.S. Attorney

Enforcement Recommended
No Action Recommended

in person

(Regional Counsel and Region)

Received

Date:
Trans In

Ret'd Trans Out

Completed

Form I-363 12/27/12 Y