I-864 Ez Ins Toc

TABLE OF CHANGES – INSTRUCTIONS

Form I-864EZ, Affidavit of Support Under Section 213A of the INA

OMB Number: 1615-0075

08/17/2020

Reason for Revision: Affidavit of Support NPRM

Project Phase: DHSReview

Legend for Proposed Text:

• Black font = Current text

• Red font = Changes

Expires 03/31/2020

Edition Date 03/06/2018

Current Page Number and Section	Current Text	Proposed Text
Page 1, Who May Use Form I-864EZ?	[Page 1] Who May Use Form I-864EZ? You may use Form I-864EZ if ALL the following conditions apply: 1. You are the person who filed or is filing Form I-130, Petition for Alien Relative, for a relative being sponsored; 2. The relative you are sponsoring is the only person listed on Form I-130; and 3. The income you are using to qualify is based entirely on your salary or pension and is shown on one or more Internal Revenue Service (IRS) Form W-2s provided by your employers or former employers.	[Page 1] Who May Use Form I-864EZ? [no change] 1. You are the person who filed or is filing Form I-129F, Petition for Alien Fiancé(e), Form I-130, Petition for Alien Relative, Form I-600, Petition to Classify Orphan as an Immediate Relative, or Form I-800, Petition to Classify Convention Adoptee as an Immediate Relative, for a relative being sponsored; 2. The relative you are sponsoring is the only person listed on the petition besides yourself; and [no change]
Page 1, When Not To Use Form I-864EZ?	[Page 1] When Not To Use Form I-864EZ? Do not use Form I-864EZ if any of the following conditions apply. Instead, you must complete and submit Form I-864. 1. The relative you are sponsoring is not the only person immigrating based upon the underlying visa petition. 2. You filed or are filing Form I-140, Immigrant Petition for Alien Worker, for the immigrant you are sponsoring. 3. You are a joint sponsor. 4. You are a substitute sponsor filing because the original Form I-130 petitioner is deceased. 5. Your salary or pension is not enough to meet the income requirements as set by the Federal Poverty Guidelines. [new]	[Page 1] When Not To Use Form I-864EZ? Do not use Form I-864EZ if any of the following conditions apply. Instead, you must complete and submit Form I-864. 1. The relative you are sponsoring is not the only person immigrating based upon the underlying visa petition. 2. You filed or are filing Form I-140, Immigrant Petition for Alien Worker, for the immigrant you are sponsoring. 3. You are a joint sponsor. 4. You are a substitute sponsor filing because the original Form I-130 petitioner is deceased. 5. Your salary or pension is not enough to meet the income requirements as set by the Federal Poverty Guidelines. 6. You have received means-tested public benefits within the past 36 months of executing this Form I-864EZ. This only applies to means-tested public benefits that you received on or after [EFFECTIVE DATE OF RULE]. 7. You have had a court judgment entered against you at any time for failing to fulfill your support or reimbursement obligations under a previous Affidavit of Support Under Section 213A of the INA, or a Contract Between Sponsor and Household Member.
Page 1, How Is Form I-864EZ Used?	[Page 1] How Is Form I-864EZ Used? This affidavit is a contract between a sponsor and the U.S. Government. The person completing and signing this affidavit is the sponsor. By signing Form I-864EZ, you are agreeing to use your income and resources to support the intending immigrant named in this affidavit, if it becomes necessary. You must show on this affidavit that you have enough income to ensure that the sponsored immigrant will not have to rely on means-tested public benefits for support in the United States. In most cases, the submission of this affidavit will make the sponsored immigrant ineligible for Federal, state, or local means-tested public benefits, because an agency that provides means-tested public benefits will consider your income and resources available to the sponsored immigrant in determining eligibility for the program. If the immigrant sponsored in this affidavit does receive a Federal, state, or local means-tested public benefit, the agency providing the benefit may require you to repay the cost of those benefits. That agency can sue you if you do not repay the cost of the benefits provided. 1. Who Is Required to File Form I-864W Instead of Form I-864 or Form I-864EZ? The following types of intending immigrants must properly complete and submit Form I-864W, Request for Exemption for Intending Immigrant’s Affidavit of Support, instead of a Form I-864 or Form I-864EZ: A. An intending immigrant who has received, or can receive credit for 40 quarters of work. The Social Security Administration can provide information on how to count and provide evidence of quarters of work; B. An intending immigrant who will, upon admission, acquire U.S. citizenship under the Immigration and Nationality Act (INA) section 320, as amended by the Child Citizenship Act of 2000 (CCA); and C. A self-petitioning widow(er) or qualifying battered spouse or child. 2. Who Completes Form I-864EZ? Only the U.S. citizen, lawful permanent resident, or U.S. national who filed Form I-130 for a family member, may complete this affidavit. A sponsor is required to be at least 18 years of age and domiciled in the United States, its territories, or possessions. (See the Specific Instructions section of these Instructions.) 3. What Are the Income Requirements? To qualify as a sponsor, you must demonstrate that you have an income of at least 125 percent of the current Federal Poverty Guidelines for your household size. The Federal poverty line, for purposes of this affidavit, is updated annually and can be found on Form I-864P, Poverty Guidelines, at www.uscis.gov/I-864P. If you are on active duty in the U.S. Armed Forces or U.S. Coast Guard and you are sponsoring your spouse or minor child, you only need to have an income of 100 percent of the Federal Poverty Guidelines for your household size. 4. How Do I Count Household Size? Your household size includes yourself and the following individuals, no matter where they live: A. Any spouse; B. Any dependent children under 21 years of age; C. Any other dependents listed on your most recent Federal income tax return; D. The person being sponsored in this affidavit of support; and E. Any immigrants previously sponsored with a Form I-864 or Form I-864EZ affidavit of support whom you are still obligated to support. 5. How Long Does My Obligation as a Sponsor Continue? Your obligation to support the immigrant you are sponsoring in this Form I-864EZ will continue until the sponsored immigrant becomes a U.S. citizen, or can receive credit for 40 qualifying quarters of work in the United States. Although 40 qualifying quarters (credits) of work generally equates to 10 years of work, in certain cases, the work of a spouse or parent adds qualifying quarters toward eligibility. The Social Security Administration can provide information on how to count qualifying quarters (credits) of work. The obligation also ends if you or the sponsored immigrant dies or if the sponsored immigrant ceases to be a lawful permanent resident and departs the United States. Divorce does not end the sponsorship obligation.	[Page 1] How Is Form I-864EZ Used? This affidavit is a contract between a sponsor and the U.S. Government. The person completing and signing this affidavit is the sponsor. By signing Form I-864EZ, you are agreeing to use your income and resources to support the intending immigrant named in this affidavit, if it becomes necessary. You must show on this affidavit that you have enough income to ensure that the sponsored immigrant will not have to rely on means-tested public benefits for support in the United States. In most cases, the submission of this affidavit will make the sponsored immigrant ineligible for Federal, state, or local means-tested public benefits, because an agency that provides means-tested public benefits will consider your income and resources available to the sponsored immigrant in determining eligibility for the program. If the immigrant sponsored in this affidavit does receive a Federal, state, or local means-tested public benefit, the agency providing the benefit may require you to repay the cost of those benefits. That agency can sue you if you do not repay the cost of the benefits provided. [deleted] 1. Who Executes Form I-864EZ? Only the U.S. citizen, lawful permanent resident, or U.S. national who petitioned for a family member using Form I-129F, Form I-130, Form I-600, or Form I-800, may execute this affidavit. A sponsor is required to be at least 18 years of age and domiciled in the United States, its territories, or possessions. (See the Specific Instructions section of these Instructions.) 2. What Are the Income Requirements? To qualify as a sponsor, you must demonstrate that you have an income of at least 125 percent of the current Federal Poverty Guidelines for your household size. The Federal poverty line, for purposes of this affidavit, is updated annually and can be found on Form I-864P, Poverty Guidelines, at www.uscis.gov/I-864P. If you are on active duty (other than active duty for training) in the U.S. Armed Forces and you are sponsoring your spouse or minor child, you only need to have an income of 100 percent of the Federal Poverty Guidelines for your household size. 3. How Do I Count Household Size? Your household size includes yourself and the following individuals, no matter where they live: A. Any spouse; B. Any dependent children under 21 years of age; C. Any other dependents listed on your most recent Federal income tax return; D. The person being sponsored in this affidavit of support; and E. Any immigrants for whom you have executed a Form I-864, Form I-864EZ, or Form I-864A contract, and for whom the support obligation is still in effect. 4. How Long Does My Obligation as a Sponsor Continue? Your obligation to support the immigrant you are sponsoring in this Form I-864EZ will continue until the sponsored immigrant becomes a U.S. citizen, or can receive credit for 40 qualifying quarters of work in the United States. Although 40 qualifying quarters (credits) of work generally equates to 10 years of work, in certain cases, the work of a spouse or parent adds qualifying quarters toward eligibility. The Social Security Administration can provide information on how to count qualifying quarters (credits) of work. The obligation also ends if you or the sponsored immigrant dies or if the sponsored immigrant ceases to be a lawful permanent resident and departs the United States. Divorce does not end the support obligation.
Pages 4-8, Specific Instructions	[Page 4] Specific Instructions Form I-864EZ is divided into nine parts. The information below will help you fill out the affidavit. Part 1. Qualifying to Use Form I-864EZ You may use Form I-864EZ if the statements in Item Numbers 1.a. - 1.c. are all true. If you do not select “Yes” for all three boxes, you do NOT qualify to use Form I-864 EZ and therefore must use Form I-864. Submission of the incorrect affidavit will delay processing. Item Number l.a. Select “Yes” if you are the petitioner who is filing or who has already filed Form I-130, Petition for Alien Relative; Form I-129F, Petition for Alien Fiancé(e); Form I-600, Petition to Classify Orphan as an Immediate Relative; or Form I-600A, Application for Advance Processing of Orphan Petition. … Part 4. Information About Your Household Size This section asks you to add together the number of persons for whom you are financially responsible. Some of these persons may not reside with you. Make sure you do not count any individual more than once, since, in some cases, the same person could fit into two categories. Item Number l.a. This line is already completed for you, and it includes the intending immigrant and you. Item Number l.b. If you are married, and your spouse was not included in Item Number 1.a., enter “1” here. Item Number l.c. Enter the number of unmarried children you have who are under 21 years of age, even if you do not have legal custody of these children. You may exclude any unmarried children under 21 years of age, if these children have reached majority under the law of their place of domicile, and you do not claim them as dependents on your Federal income tax returns. Item Number l.d. Enter the number of lawful permanent residents whom you are currently obligated to support based on your previous submissions of Form I-864 or Form I-864EZ as a petitioning, substitute, or joint sponsor. Include only those persons who have already immigrated to the United States. Do not include anyone for whom your obligation to support has ended through the sponsored immigrant’s acquisition of U.S. citizenship, death, abandonment of lawful permanent residence in the United States, acquisition of 40 quarters of earned or credited work in the United States, or obtaining a new grant of adjustment of status while in removal proceedings based on a new affidavit of support, if one is required. [Page 7] Item Number l.e. Enter the number of any other dependents. You must include every person whom you have claimed as a dependent on your most recent Federal income tax return, even if that person is not related to you. Even if you are not legally obligated to support that person, you must include the person if in fact you did support that person and claimed the person as a dependent. Item Number 1.f. Add together Item Numbers 1.a. - 1.e. and enter the number in the space provided. [new] Part 5. Information About Your Employment and Income … Item Number 4. Current Individual Annual Income. Enter your current individual earned or retirement annual income that you are using to meet the requirements of this affidavit and indicate the total on this line. You may include evidence supporting your claim about your expected income for the current year if you believe that submitting this evidence will help you establish the ability to maintain sufficient income. You are not required to submit this evidence, however, unless specifically instructed to do so by a Government official. For example, you may include a recent letter from your employer showing your employer’s address and telephone number and indicating your annual salary. You may also provide pay stubs showing your income for the previous six months. Item Numbers 5.a. - 6.c. Federal Income Tax Information. You must provide either an IRS transcript or a photocopy from your own records of your Federal individual income tax return for the most recent tax year. If you believe additional returns may help you to establish your ability to maintain sufficient income, you may submit transcripts or photocopies of your Federal individual income tax returns for the three most recent years. You are not required to have the IRS certify the transcript or photocopy unless specifically instructed to do so by a Government official; a plain transcript or photocopy is acceptable. Do not submit copies of your state income tax returns. Do not submit any tax returns that you filed with any foreign government unless you claim that you were not required to file a Federal income tax return with the United States government, and you wish to rely on the foreign return solely to establish the amount of your income that is not subject to tax in the United States. If you provide a photocopy of your tax returns, you must include a copy of each and every FormW-2 and Form 1099 that relates to your returns. Do not include copies of these forms if you provide an IRS transcript of your returns rather than a photocopy unless you filed a joint tax return with your spouse. If you were required to file a Federal income tax return for the most recent tax year but did not do so, you must file any and all late returns with the IRS and attach an IRS-generated tax return transcript documenting your late filing before submitting the I-864EZ. If you were not required to file a Federal income tax return under U.S. tax law for any other reason, attach a typed or printed explanation including evidence of the exemption and how you are subject to it. Residence outside of the United States does not exempt U.S. citizens or lawful permanent residents from filing a U.S. Federal income tax return. See “Filing Requirements” in the IRS Form 1040 Filing Instructions to determine whether you were required to file. For purposes of this affidavit, the line for Total income on IRS Forms 1040 and 1040A is considered when determining income. For persons filing IRS Form 1040EZ, the line for adjusted gross income is considered. Obtaining Tax Transcripts. You may use IRS Form 4506-T to request tax transcripts from the IRS. Complete IRS Form 4506-T with the ending date for each of your three most recent tax years listed on line 9. Follow all instructions for completing and filing Form 4506-T with the IRS. [new] Part 6. Sponsor’s Contract, Statement, Contact Information, Declaration, Certification, and Signature Read the contract carefully and then sign and date the affidavit. If you do not sign and date your Form I-864EZ in Item Numbers 6.a. - 6.b., the immigrant you are sponsoring cannot be issued a visa or be granted adjustment of status. Item Numbers 1.a. - 6.b. Select the appropriate box to indicate whether you read this affidavit yourself or whether you had an interpreter assist you. Further, you must sign and date your affidavit and provide your daytime telephone number, mobile telephone number (if any), and email address (if any). Every affidavit MUST contain the signature of the sponsor (or parent or legal guardian, if applicable). A stamped or typewritten name in place of a signature is not acceptable. If you are under guardianship, your legal guardian may print your name and sign Form I-864EZ for you. See General Instructions for definition of “legal guardian.” Part 7. Interpreter’s Contact Information, Certification, and Signature Item Numbers 1.a. - 7.b. If you used anyone as an interpreter to read the instructions and questions on this affidavit to you in a language in which you are fluent, the interpreter must fill out this section, provide his or her name, the name and address of his or her business or organization (if any), his or her daytime telephone number, his or her mobile telephone number (if any), and his or her email address (if any). The interpreter must sign and date the affidavit. Part 8. Contact Information, Declaration, and Signature of the Person Preparing this Affidavit, if Other Than the Sponsor Item Numbers 1.a. - 8.b. This section must contain the signature of the person who completed your affidavit, if other than you, the sponsor. If the same individual acted as both your interpreter and preparer, that person should complete both Part 7. and Part 8. If the person who completed this affidavit is associated with a business or organization, that person should complete the business or organization name and address information. Anyone who helped you prepare this affidavit MUST sign and date the affidavit. A stamped or typewritten name in place of a signature is not acceptable. If the person who helped you complete your affidavit is an attorney or accredited representative, he or she may be obliged to also submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative or G-28I, Notice of Entry of Appearance as Attorney In Matters Outside the Geographical Confines of the United States, along with your affidavit. Part 9. Additional Information Item Numbers 1.a. - 7.d. If you need extra space to provide any additional information within this affidavit, use the space provided in Part 9. Additional Information. If you need more space than what is provided in Part 9., you may make copies of Part 9. to complete and file with your affidavit, or attach a separate sheet of paper. Type or print your name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet. We recommend that you print or save a copy of your completed contract to review in the future and for your records.	[Page 4] [no changes] Item Number l.a. Select “Yes” if you are the petitioner who is filing or who has already filed Form I-130, Petition for Alien Relative; Form I-129F, Petition for Alien Fiancé(e); Form I-600, Petition to Classify Orphan as an Immediate Relative; or Form I-800, Petition to Classify Convention Adoptee as an Immediate Relative. … [no change] Item Number l.d - 1.e. Enter the number of lawful permanent residents and intending immigrants for whom you have executed Form I-864, Form I-864EZ, or Form I-864A (as a household member) for whom the support obligation has not ended. Do not include anyone for whom your obligation to support has ended through the sponsored immigrant’s acquisition of U.S. citizenship, death, abandonment of lawful permanent residence in the United States, acquisition of 40 quarters of earned or credited work in the United States, or obtaining a new grant of adjustment of status while in removal proceedings based on a new affidavit of support, if one is required. Item Number l.f. Enter the number of any other dependents. You must include every person whom you have claimed as a dependent on your most recent Federal income tax return, even if that person is not related to you. Even if you are not legally obligated to support that person, you must include the person if in fact you did support that person and claimed the person as a dependent. Item Number 1.g. Add together Item Numbers 1.a. - 1.e. and enter the number in the space provided. Part 5. Previously Submitted Form I-864, Form I-864EZ, or Form I-864A Item Number 1. Select “Yes” if you have executed Form I-864, Form I-864EZ, or Form I-864A for any individuals other than the intending immigrant listed on this form. Select “No” if you have never executed Form I-864, Form I-864EZ, or Form I-864A on behalf on any other individual. Item Number 2. If you selected “Yes” to Part 5. Item Number 1., type or print the total number of individuals for whom you have previously executed Form I-864, Form I-864EZ, or Form I-864A. Include all sponsored immigrants for whom you have executed Form I-864, Form I-864EZ, or Form I-864A who have been approved for lawful permanent residence status or whose Form I-864, Form I-864EZ, or Form I-864A is still pending. NOTE: Your support obligation has ended for an individual if: 1) the individual became a United States citizen, 2) the individual is currently a lawful permanent resident that has worked or can be credited with 40 qualifying quarters of coverage, 3) the individual abandoned or lost his or her lawful permanent resident status, 4) the individual is deceased, 5) you are deceased, or 6) the individual is obtaining a new grant of adjustment of status while in removal proceedings based on a new affidavit of support, if one is required. Item Numbers 3.a. - 8. Sponsored Individuals. If you have sponsored any other individuals using Form I-864, Form I-864EZ, or have previously executed Form I-864A you should list the names and other requested information in the spaces provided in Item Numbers 3.a. - 8. Item Number 9. Indicate whether or not you have had to reimburse an agency for any means-tested public benefits issued to a sponsored immigrant as part of your support obligation as sponsor or household member. If you answer “Yes,” indicate the name of the agency and the amount you were required to reimburse in Part 10. Additional Information. Attach evidence that you have fully reimbursed the agency with the amount owed. Part 6. Information About Your Employment and Income [no changes] Item Number 4. Current Individual Annual Income. Enter your current individual earned or retirement annual income that you are using to meet the requirements of this affidavit and indicate the total on this line. You may include evidence supporting your claim about your expected income for the current year if you believe that submitting this evidence will help you establish the ability to maintain sufficient income. You are not required to submit this evidence, however, unless specifically instructed to do so by a Government official. For example, you may include a recent letter from your employer showing your employer’s address and telephone number and indicating your annual salary. You may also provide pay stubs showing your income for the previous six months. You, as the sponsor, may not rely on any income accrued or earned from unlawful enterprises or unlawful activities, such as proceeds from illegal gambling or drug sales, to meet the income requirement even if federal income taxes were paid on that income. Item Numbers 5.a. - 6.c. Federal Income Tax Information. You must provide either IRS-issued certified copies or transcripts of your Federal individual income tax return for the three most recent tax years. Photocopies are not acceptable. [deleted] Do not submit copies of your state income tax returns. Do not submit any tax returns that you filed with any foreign government unless you claim that you were not required to file a Federal income tax return with the United States government, and you wish to rely on the foreign return solely to establish the amount of your income that is not subject to tax in the United States. [deleted] If you were required to file a Federal income tax return for any of the three most recent tax years but did not do so, you must file any and all late returns with the IRS and attach an IRS-generated tax return transcript documenting your late filing before submitting the I-864EZ. If you were not required to file a Federal income tax return under U.S. tax law for any other reason, attach a typed or printed explanation including evidence of the exemption and how you are subject to it. Residence outside of the United States does not exempt U.S. citizens or lawful permanent residents from filing a U.S. Federal income tax return. See “Filing Requirements” in the IRS Form 1040 Filing Instructions to determine whether you were required to file. For purposes of this affidavit, the line for Total income on IRS Forms 1040 and 1040A is considered when determining income. For persons filing IRS Form 1040EZ, the line for adjusted gross income is considered. Obtaining Tax Transcripts. You may use IRS Form 4506-T to request tax transcripts from the IRS, and Form 4506 to request copies of your tax returns. Complete IRS Form 4506-T or IRS Form 4506 with the ending date for each of your three most recent tax years listed on line 9. Follow all instructions for completing and filing Form 4506-T or Form 4506 with the IRS. Item Numbers 7. - 12. Sponsor’s Bank Account Information. Provide the account type, name(s) of all account holders, the name of the banking institution, the number of the checking or savings account, and the corresponding routing number for the account that you are using to establish your financial eligibility. Item Number 13. Credit Report and Credit Score. You must provide a copy of a U.S. credit report and credit score generated within the last 12 months prior to the date of submission, if available, with your Form I-864EZ. You can obtain a free credit report once a year under the Fair Credit Reporting Act from each one of the three credit reporting agencies. You are only required to provide one credit report from any of the three nationwide credit reporting agencies, Equifax, Experian, and TransUnion. See https://www.usa.gov/credit-reports for more information. If there are any errors in the credit report, you should provide evidence from the credit reporting agency that demonstrates that you reported the error and that the error is under investigation or has been resolved. If you have any negative history in your credit report, you may provide an explanation in the designated area of this form. Negative credit history may include delinquent accounts, debt collections, charge-offs (delinquent accounts deemed unlikely to be collected), repossession, foreclosure, judgments, tax liens, or bankruptcy on your credit report. If you do not have a credit report or credit score, provide documentation that demonstrates that you do not have a credit report or score with a credit bureau. You may provide evidence of continued payment of bills if there is no credit report or credit score. Part 7. Sponsor’s Contract, Statement, Contact Information, Declaration, Certification, and Signature Read the contract carefully and then sign and date the affidavit. If you do not sign and date your Form I-864EZ in Item Numbers 6.a. - 6.b., the immigrant you are sponsoring cannot be issued a visa or be granted adjustment of status. Item Numbers 1.a. - 6.b. Select the appropriate box to indicate whether you read this affidavit yourself or whether you had an interpreter assist you. Further, you must sign and date your affidavit and provide your daytime telephone number, mobile telephone number (if any), and email address (if any). Every affidavit MUST contain the signature of the sponsor (or parent or legal guardian, if applicable). A stamped or typewritten name in place of a signature is not acceptable. If you are under guardianship, your legal guardian may print your name and sign Form I-864EZ for you. See General Instructions for definition of “legal guardian.” Part 8. Interpreter’s Contact Information, Certification, and Signature Item Numbers 1.a. - 7.b. If you used anyone as an interpreter to read the instructions and questions on this affidavit to you in a language in which you are fluent, the interpreter must fill out this section, provide his or her name, the name and address of his or her business or organization (if any), his or her daytime telephone number, his or her mobile telephone number (if any), and his or her email address (if any). The interpreter must sign and date the affidavit. Part 9. Contact Information, Declaration, and Signature of the Person Preparing this Affidavit, if Other Than the Sponsor Item Numbers 1.a. - 8.b. This section must contain the signature of the person who completed your affidavit, if other than you, the sponsor. If the same individual acted as both your interpreter and preparer, that person should complete both Part 8. and Part 9. If the person who completed this affidavit is associated with a business or organization, that person should complete the business or organization name and address information. Anyone who helped you prepare this affidavit MUST sign and date the affidavit. A stamped or typewritten name in place of a signature is not acceptable. If the person who helped you complete your affidavit is an attorney or accredited representative, he or she may be obliged to also submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative or G-28I, Notice of Entry of Appearance as Attorney In Matters Outside the Geographical Confines of the United States, along with your affidavit. Part 10. Additional Information Item Numbers 1.a. - 7.d. If you need extra space to provide any additional information within this affidavit, use the space provided in Part 10. Additional Information. If you need more space than what is provided in Part 10., you may make copies of Part 10. to complete and file with your affidavit, or attach a separate sheet of paper. Type or print your name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet. We recommend that you print or save a copy of your completed contract to review in the future and for your records.
Page 9, Address Change	[Page 9] Address Change A sponsor who is not a U.S. citizen must notify USCIS of his or her new address within 10 days of moving from his or her previous residence. To do this you must complete and file Form I-865, Sponsor’s Change of Address. For information on filing Form I-865, go to the USCIS website at www.uscis.gov/I-865 or contact the USCIS National Customer Service Center at 1-800-375-5283. For TTY (deaf or hard of hearing) call: 1-800-767-1833. If you are a lawful permanent resident sponsor, you must notify USCIS of your new address within 10 days of moving from your previous residence. For information on filing a change of address go to the USCIS website at www.uscis.gov/addresschange or contact the USCIS National Customer Service Center at 1-800-375-5283. For TTY (deaf or hard of hearing) call: 1-800-767-1833. For information on reporting a change of address to the Department of State, see www.travel.state.gov. NOTE: Do not complete Form I-865 at the same time that you complete Form I-864EZ. You should complete and submit Form I-865 to USCIS only when the address you indicated on the original Form I-864EZ has changed. NOTE: Do not submit a change of address request to the USCIS Lockbox facilities because the Lockbox does not process change of address requests.	[Page x] Address Change If you are a sponsor who is not a U.S. citizen or U.S. national, you must notify USCIS of your new address within 30 days of moving from your previous residence. To do this you must file Form I-865, Notice of Change of Address for Sponsors and Household Members. If you are a lawful permanent resident sponsor, you must notify USCIS of your new address within 10 days of moving from your previous residence. For information on filing a change of address go to the USCIS website at www.uscis.gov/addresschange or contact the USCIS National Customer Service Center at 1-800-375-5283. For TTY (deaf or hard of hearing) call: 1-800-767-1833. For information on reporting a change of address to the Department of State, see www.travel.state.gov. If you are a sponsor who is a U.S. citizen or a U.S. national, you must notify USCIS of your new address within 30 days of moving from your previous address. To do this you must complete and file Form I-865, Notice of Change of Address for Sponsors and Household Members. For information on filing Form I-865, go to the USCIS website at www.uscis.gov/I-865 or contact the USCIS National Customer Service Center at 1-800-375-5283. For TTY (deaf or hard of hearing) call: 1-800-767-1833. NOTE: Do not complete Form I-865 at the same time that you complete Form I-864EZ. You should complete and submit Form I-865 to USCIS only when the address you indicated on the original Form I-864EZ has changed. NOTE: Do not submit a change of address request to the USCIS Lockbox facilities because the Lockbox does not process change of address requests.
Page 10, USCIS Privacy Act Statement	[Page 10] USCIS Privacy Act Statement AUTHORITIES: The information requested on this affidavit, and the associated evidence, is collected under the Immigration and Nationality Act section 213A. PURPOSE: The primary purpose for providing the requested information on this affidavit is to show that the applying immigrant has adequate means of financial support without concern of becoming reliant on the U.S. Government for financial support. DHS will use the information you provide to grant or deny the immigration benefit you are seeking. DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and any requested evidence, may delay a final decision in your case or result in denial of your affidavit. INA section 213A(i) requires the collection of your Social Security number. Failure to provide the requested information, and any requested evidence, may prevent USCIS from accepting and approving this affidavit, and the intending immigrant may not be able to immigrate to the United States. ROUTINE USES: DHS may share the information you provide on this affidavit with other Federal, state, local, and foreign government agencies and authorized organizations. DHS follows approved routine uses described in the associated published system of records notices [DHS/USCIS-007- Benefits Information System, and DHS/USCIS-001- Alien File, Index, and National File Tracking System of Records] which you can find at www.dhs.gov/privacy. DHS may also share the information, as appropriate, for law enforcement purposes or in the interest of national security.	[Page 10] DHS Privacy Notice AUTHORITIES: The information requested on this affidavit, and the associated evidence, is collected under the Immigration and Nationality Act (INA) sections 212(a)(4) and 213A. PURPOSE: The primary purpose for providing the requested information on this affidavit is for you, the sponsor, to demonstrate that you meet the eligibility requirements to execute this contract between a sponsor and the U.S. government that imposes on the sponsor a legally enforceable obligation to support a sponsored alien until the obligation terminates. An alien applicant who fails to submit a sufficient Affidavit of Support Under Section 213A of the INA, when statutorily required, will be found inadmissible under section 212(a)(4) of the INA. DHS will uses the information you provide as part of determining whether or not the adjustment of status applicant or the immigrant visa applicant you are sponsoring is eligible for the immigration benefit. DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, including your Social Security number (if applicable), and any requested evidence, may delay a decision on whether the affidavit is found sufficient to meet the requirements of INA section 213A, or may result in the affidavit being found insufficient. ROUTINE USES: DHS may share the information you provide on this affidavit and any additional requested evidence with other Federal, state, local, and foreign government agencies and authorized organizations. DHS follows approved routine uses described in the associated published system of records notices [DHS/USCIS/ICE/CBP-001- Alien File, Index, and National File Tracking System, DHS/USCIS-007- Benefits Information System, and DHS/USCIS-018 Immigration Biometric and Background Check] and the published privacy impact assessments [DHS/USCIS/PIA-016a Computer Linked Application Information Management System and Associated Systems and DHS/USCIS/PIA-056 USCIS Electronic Immigration System] which you can find at www.dhs.gov/privacy. DHS may also share this information, as appropriate, for law enforcement purposes or in the interest of national security.
Page 11	[Page 11] Paperwork Reduction Act An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection of information, unless it displays a currently valid Office of Management and Budget (OMB) control number. The public reporting burden for this collection of information is estimated at 2 hours and 30 minutes per response, including the time for reviewing instructions, gathering the required documentation and information, completing the affidavit, preparing statements, attaching necessary documentation, and submitting the affidavit. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave NW, Washington, DC 20529-2140; OMB No. 1615-0075. Do not mail your completed Form I-864EZ to this address.	Paperwork Reduction Act An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection of information, unless it displays a currently valid Office of Management and Budget (OMB) control number. The public reporting burden for this collection of information is estimated at 3 hours per response, including the time for reviewing instructions, gathering the required documentation and information, completing the affidavit, preparing statements, attaching necessary documentation, and submitting the affidavit. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave NW, Washington, DC 20529-2140; OMB No. 1615-0075. Do not mail your completed Form I-864EZ to this address.
Page 11, Checklist	[Page 11] Checklist The following items must be submitted with Form I-864EZ: For ALL sponsors: [] A copy of your individual Federal income tax return, including W-2s for the most recent tax year, or a statement and/or evidence describing why you were not required to file. Also include a copy of each and every Form 1099, Schedule, and any other evidence of reported income. You may submit this information for the three most recent tax years, pay stubs from the most recent six months, and/or a letter from your employer if you believe any of these items will help you qualify. [new] For SOME sponsors: [] If you are on active duty in the U.S. Armed Forces or U.S. Coast Guard and are sponsoring your spouse or child using the 100 percent of the Federal Poverty Guidelines, provide proof of your active military status. [] If your legal guardian is signing this Form I-864EZ for you, the legal guardian must present: [] Proof of the appointment as legal guardian of your estate; and [] A copy of an order from the appointing court or agency specifically permitting the legal guardian to make your income and assets available for the support of the sponsored immigrant.	[Page x] Checklist The following items must be submitted with Form I-864EZ: For ALL sponsors: [] IRS-issued certified copies or transcripts of your individual Federal income tax return for the three most recent tax years, or a statement and/or evidence describing why you were not required to file. Also include a copy of each and every Form 1099, Schedule, and any other evidence of reported income. You may submit pay stubs from the most recent six months, and/or a letter from your employer if you believe any of these items will help you qualify. [] A copy of a U.S. credit report and credit score generated within the last 12 months prior to the date of submission, if available, with your Form I-864EZ, or a credit agency report that demonstrates that you do not have a credit report or score. For SOME sponsors: [] If you are on active duty in the U.S. Armed Forces and are sponsoring your spouse or child using the 100 percent of the Federal Poverty Guidelines, provide proof of your active military status. [] If your legal guardian is signing this Form I-864EZ for you, the legal guardian must present: [] Proof of the appointment as legal guardian of your estate; and [] A copy of an order from the appointing court or agency specifically permitting the legal guardian to make your income and assets available for the support of the sponsored immigrant.

1