Affidavit of Support Under Section 213A of the Act

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form I-864 Affidavit of Support Under Section 213A of the INA	Form	Modified	Available
Form I-864W Request for Exemption for Intending Immigrant's Affidavit of Support	Form	New	Available
Form I-864EZ Affiavit of Support of Support Under Section 213A of the Act	Form	Modified	Available
Form I-864A Contract Between Sponsor and Household Member	Form	Modified	Available
Public Charge Emergency Memo Final v4.pdf	Supplementary Document	Uploaded 2020-08-10	Available
I864EZ-INS-TOC-PCINJrollback-08062020.docx	Supplementary Document	Uploaded 2020-08-07	Available
I864-INS-TOC-PCInjRollback-08072020.docx	Supplementary Document	Uploaded 2020-08-07	Available
I-864-008-Supporting Statement.docx	Supporting Statement A	Uploaded 2020-08-06	Available
privacy-pia-016a-uscis-claims3-march25,2016.pdf	Supplementary Document	Uploaded 2017-05-16	Available
SORN 007 Benefits Info Sys 2016 10 19.pdf	Supplementary Document	Uploaded 2017-06-27	Available
SORN 001 AFileIndexNFTS 2013 11 21.html	Supplementary Document	Uploaded 2017-05-16	Repair queued
71 FR 35732, 35739.doc	Supplementary Document	Uploaded 2017-05-16	Repair queued
Dep of State Foreign Affairs Manual Volume 9-Visas.pdf	Supplementary Document	Uploaded 2017-05-16	Available
USCIS memo (Consolidation of Policy of USCIS Form I-864).pdf	Supplementary Document	Uploaded 2017-05-16	Available
Section 213A.doc	Supplementary Document	Uploaded 2017-05-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
41275	Affidvit of Support Under Section 213A of the Act	Form	Modified	Affidavit of Support Under Section 213A of the INA
41275	Affidvit of Support Under Section 213A of the Act	Instruction	Modified
243051	Request for Exemption of Intending Immigrant's Affidavit of Support	Form	New	Request for Exemption for Intending Immigrant's Affidavit of Support
243051	Request for Exemption of Intending Immigrant's Affidavit of Support	Instruction	New
204186	Affidavit of Support Under Section 213A of the Act	Form	Modified	Affiavit of Support of Support Under Section 213A of the Act
204186	Affidavit of Support Under Section 213A of the Act	Instruction	Modified
204184	Contract Between Sponsor and Household Member	Form	Modified	Contract Between Sponsor and Household Member
204184	Contract Between Sponsor and Household Member	Instruction	Modified

ICR Details

OMB Control No: 1615-0075	ICR Reference No: 202008-1615-016
Status: Historical Inactive	Previous ICR Reference No: 201907-1615-016
Agency/Subagency: DHS/USCIS	Agency Tracking No: I-864
Title: Affidavit of Support Under Section 213A of the Act
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 08/11/2020
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 08/28/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/10/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2021	6 Months From Approved	10/31/2021
Responses	769,145	0	769,145
Time Burden (Hours)	3,347,720	0	3,347,720
Cost Burden (Dollars)	135,569,525	0	135,569,525

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Abstract: USCIS uses the data collected on Form I-864 to determine whether the sponsor has the ability to support the sponsored alien under section 213A of the Immigration and Nationality Act. This form standardizes evaluation of a sponsor’s ability to support the sponsored alien and ensures that basic information required to assess eligibility is provided by petitioners. Form I-864A is a contract between the sponsor and the sponsor’s household members. It is only required if the sponsor used the income of his or her household members to reach the required 125 percent of the Federal poverty guidelines. The contract holds these household members jointly and severally liable for the support of the sponsored immigrant. The information collection required on Form I-864A is necessary for public benefit agencies to enforce the Affidavit of Support in the event the sponsor used income of his or her household members to reach the required income level and the public benefit agencies are requesting reimbursement from the sponsor. USCIS uses Form I-864EZ in exactly the same way as Form I-864; however, less information is collected from the sponsors as less information is needed from those who qualify in order to make a thorough adjudication. USCIS uses Form I-864W to determine whether the intending immigrant meets the criteria for exemption of section 213A requirements. This form collects the immigrant’s basic information, such as name and address, the reason for the exemption, and accompanying documentation in support of the immigrant’s claim that they are not subject to section 213A.

Emergency Justfication: On Wednesday, July 29, 2020, DHS was enjoined by the U.S. District Court for the Southern District of New York from enforcing, applying, implementing, or treating as effective the Public Charge Final Rule, which was implemented on February 24, 2020. USCIS has been advised by the U.S. Department of Justice that the nationwide injunction covers the use of this information collection instrument approved with the Public Charge Final Rule. In light of the injunction, USCIS will need to revise this form to remove the information collection elements added pursuant to the Public Charge Final Rule.

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Authorizing Statute(s): US Code: 8 USC 1183a Name of Law: Immigration Nationality Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Affidavit of Support Under Section 213A of the Act	I-864EZ	Affiavit of Support of Support Under Section 213A of the Act
Affidvit of Support Under Section 213A of the Act	I-864	Affidavit of Support Under Section 213A of the INA
Contract Between Sponsor and Household Member	I-864A	Contract Between Sponsor and Household Member
Request for Exemption of Intending Immigrant's Affidavit of Support	I-864W	Request for Exemption for Intending Immigrant's Affidavit of Support

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Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: USCIS is reinstating Form I-864W to this information collection as a result of the injunction on the Public Charge Final Rule.

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Annual Cost to Federal Government: $22,133,800

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/10/2020

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