Form I-134A Online Request to be a Supporter and Declaration of Fina

Online Request to be a Supporter and Declaration of Financial Support

I-134A-005 PRA Revision Copydeck v2.2.1

Online Request to be a Supporter and Declaration of Financial Support

OMB: 1615-0157

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1615-0157 can be found here:

Document [pdf]

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Form Number and Name
OMB Number
Form Edition Date:
Form Expiration Date:
Baseline Copydeck:

I-134A, Online Request to be a Supporter and Declaration of Financial Support
1615-0157
4/25/2022
7/31/2023
I-134A-003 PRA Revision Copydeck v2.0.15

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1. Oranges
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Copydeck Version Info

FILE A FORM: I-134A

Column Header Descriptions
Header: If needed, a header is located directly under the dropdown menu and above the body text.
Body Text: Based on the purpose of the form found in the paper form instructions.
Link: A reference column to include any URLs that appear as hyperlinks in the body text.
CTA: Copy to include for a button.
Heading

Body Text

Select the form you want to file online

Some immigration benefits that involve a temporary stay in the United States
require U.S. Citizenship and Immigration Services (USCIS) to determine
whether the applicant or beneficiary of the request has sufficient financial
resources or financial support to pay for expenses during the temporary stay.
The individual who submits Form I-134A must establish that they have both
sufficient financial resources and access to those funds to support the
beneficiary listed on Form I-134A for the duration of the beneficiary’s stay in
the United States.

Alert

Revision

Link

CTA

Notes

Start form

[yellow alert]
[h] We are only accepting online filing of Form I-134A from individuals agreeing to financially support eligible
beneficiaries from the following countries:

[yellow alert]
[h] We are only accepting online filing of Form I-134A from individuals agreeing to financially support eligible beneficiaries from
the following countries:

[b]
• Cuba
• Colombia
• El Salvador
• Guatemala
• Haiti
• Honduras
• Nicaragua
• Ukraine
• Venezuela

[b]
• Cuba
• Colombia
• El Salvador
• Ecuador
• Guatemala
• Haiti
• Honduras
• Nicaragua
• Ukraine
• Venezuela

You must be located in the United States to file Form I-134A online. Individuals seeking parole through these
processes may not file Form I-134A on their own behalf. Supporters must include the name of the beneficiary on
Form I-134A.
Supporters must file a separate Form I-134A for each beneficiary they are planning to support, including minor
children.
To be eligible for this process, children under the age of 18 must be traveling to the United States in the care and
custody of their parent or legal guardian and be able to provide documentation to confirm the relationship.

https://www.uscis.gov/i-134

You must be located in the United States to file Form I-134A online. Individuals seeking parole through these processes may not
file Form I-134A on their own behalf. Supporters must include the name of the beneficiary on Form I-134A.
Supporters must file a separate Form I-134A for each beneficiary they are planning to support, including minor children.
To be eligible for this process, children under the age of 18 must be traveling to the United States in the care and custody of their
parent or legal guardian and be able to provide documentation to confirm the relationship.

If you are agreeing to support a beneficiary who is not seeking consideration for parole under one of these programs or processes,
If you are agreeing to support a beneficiary who is not seeking consideration for parole under one of these programs you must file a paper Form I-134 through the appropriate Lockbox location.
or processes, you must file a paper Form I-134 through the appropriate Lockbox location.

File-A-Form

APPLICATION OVERVIEW: I-134A

C l

i ti

Heading

Sub-Heading

Conditional Logic

I-134A, Online Request To Be
A Supporter And Declaration
Of Financial Support

Body Text

Revisions

Alert

Required?

Link

CTA

Notes

Some immigration benefits that involve a temporary stay in the United States require U.S. Citizenship and Immigration Services (USCIS) to determine whether the applicant or beneficiary
of the request has sufficient financial resources or financial support to pay for expenses during the temporary stay. The individual who submits Form I-134A must establish that they have
both sufficient financial resources and access to those funds to support the beneficiary listed on Form I-134A for the duration of the beneficiary’s stay in the United States.
[yellow alert]

[yellow alert]
[yellow alert]
[h] We are only accepting online filing of Form I-134A from individuals agreeing to financially support eligible beneficiaries from the following [h] We are only accepting online filing of Form I-134A from individuals agreeing to financially support eligible beneficiaries from the following
countries:
countries:
[b]
• Cuba
• Colombia
• El Salvador
• Guatemala
• Haiti
• Honduras
• Nicaragua
• Ukraine
• Venezuela
You must be located in the United States to file Form I-134A online. Individuals seeking parole through these processes may not file Form I134A on their own behalf. Supporters must include the name of the beneficiary on Form I-134A.
Supporters must file a separate Form I-134A for each beneficiary they are planning to support, including minor children.
To be eligible for this process, children under the age of 18 must be traveling to the United States in the care and custody of their parent or
legal guardian and be able to provide documentation to confirm the relationship.
If you are agreeing to support a beneficiary who is not seeking consideration for parole under one of these programs or processes, you must
file a paper Form I-134 through the appropriate Lockbox location.

Before You Start Your
Declaration

Revision

Eligibility

Fee
Documents you may need

https://www.uscis.gov/i-134

[b]
• Cuba
• Colombia
• Ecuador
• El Salvador
• Guatemala
• Haiti
• Honduras
• Nicaragua
• Ukraine
• Venezuela
You must be located in the United States to file Form I-134A online. Individuals seeking parole through these processes may not file Form I134A on their own behalf. Supporters must include the name of the beneficiary on Form I-134A.
Supporters must file a separate Form I-134A for each beneficiary they are planning to support, including minor children.
To be eligible for this process, children under the age of 18 must be traveling to the United States in the care and custody of their parent or
legal guardian and be able to provide documentation to confirm the relationship.
If you are agreeing to support a beneficiary who is not seeking consideration for parole under one of these programs or processes, you must
file a paper Form I-134 through the appropriate Lockbox location.

Whether the beneficiary of this Form I-134A will have sufficient means of support while in the United States is an important factor in determining whether to exercise discretion to
authorize parole. We require evidence that the beneficiary of this Form I-134A has financial support for the duration of their stay in the United States. Lack of evidence of financial
support while in the United States is a strong negative factor that may lead to a denial of parole.
There is no fee to file Form I-134A.
As the beneficiary's financial supporter, you must show you have sufficient income or financial resources to support the beneficiary.
Evidence should consist of any of the applicable documents listed below:
1. Statement from an officer of the bank or other financial institutions with deposits, identifying the following details regarding the account:
• Date account opened;
• Total amount deposited for the past year; and
• Present balance.
2. Statement(s) from your employer on business letterhead showing:
• Date and nature of employment;
• Salary paid; and
• Whether the position is temporary or permanent
3. Copy of last U.S. federal income tax return filed (tax transcript); or
4. List containing serial numbers and denominations of bonds and name of record owner(s).
If you are filing for a beneficiary under the Family Reunification Parole (FRP) process and they are a derivative of the principal beneficiary listed on the approved USCIS Form I-130,
Petition for Alien Relative, provide documentation showing the relationship between the USCIS Form I-130 principle beneficiary and the beneficiary listed in this form. Evidence could
include: marriage certificate, birth certificate, adoption certificate, divorce decree, and death certificate when applicable.

Biometric services
appointment

USCIS may require that you appear for an interview or provide biometrics (fingerprints, photograph, and/or signature) at any time to verify your identity, obtain additional information,
and conduct background and security checks, including a check of criminal history records maintained by the Federal Bureau of Investigation (FBI), before making a decision on your
application or petition. After USCIS receives your declaration and ensures it is complete, we will inform you if you need to attend a biometric services appointment. If an appointment is
necessary, the notice will provide you the location of you local or designated USCIS application Support Center (ASC) and the date and time of your appointment or, if you are currently
overseas, instruct you to contact a U.S. Embassy, U.S. Consulate, or USCIS office outside the United States to set up an appointment.
If you are required to provide biometrics, at your appointment you must sign an oath reaffirming that:
1. You provided or authorized all information in the declaration;
2. You reviewed and understood all of the information contained in, and submitted with your declaration; and;
3. All of this information was complete, true, and correct at the time of filing.

After You Submit Your
Declaration

Track your case online

After you submit your form, you can track its status through your USCIS account. Sign in to your account often to check your case status and read any important messages from USCIS.

Respond to requests for
information
Receive your decision

If we need more information from you, we will send you a Request for Evidence (RFE) or Request for Information (RFI). You can respond to our request and upload your documents
through your USCIS account.
USCIS' determination to confirm or not to confirm your Form I-134A is based on whether you have established you have sufficient resources to support the beneficiary for the duration
of their parole period in the United States. USCIS will notify you of the determination in writing.
Submitting your declaration online is the same as mailing in a completed paper form. They both gather the same information.

Completing Your Form Online Filing online
Complete the Getting Started
section first
Provide as many responses as
you can
We will automatically save
your responses
How to continue filling out
your form
DHS Privacy Notice

You should answer all questions in the Getting Started section first so we can best customize the rest of your online form experience.
You should provide as many responses as you can. Incomplete fields or sections and missing information can slow down the process after you submit your form.
We will automatically save your information when you select next to go to a new page or navigate to another section of the form. We will save your information for 30 days from today,
or from the last time you worked on the form.
After you start your form, you can sign in to your account to continue your form.
AUTHORITIES: The information requested on this declaration, and the associated evidence, is collected under the Immigration and Nationality Act sections 212(d)(5), 214 and 248.
PURPOSE: The primary purpose for providing the requested information on this declaration of financial support is to determine whether the beneficiary of this declaration has adequate
financial means to support themselves and that, if this individual is admitted or paroled into the United States, this individual has sufficient financial resources available to them for the
duration of their temporary stay in the United States. DHS uses the information you provide to grant or deny the immigration benefit the beneficiary of Form I-134A is seeking.
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 final decision or result in denial of the beneficiary’s benefit request.
ROUTINE USES: DHS may share the information you provide on this declaration 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 U.S. Customs and Border Protection (CBP)
DHS/CBP/PIA-024 Arrival and Departure Information System and DHS/CBP/PIA-068 CBP One Mobile Application] and the published privacy impact assessments [DHS/USCIS/PIA-003
Integrated Digitization Document Management Program (IDDMP), DHS/USCIS/PIA-051 Case and Activity Management for International Operations, DHS/USCIS/PIA-056 USCIS Electronic
Immigration System, and DHS/USCIS/PIA-071 myUSCIS Account Experience] 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.

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 2.00 hours per response, including the time for reviewing
instructions, gathering the required documentation and information, completing the declaration, preparing statements, attaching necessary documentation, and submitting the
declaration. 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
Office of Policy and Strategy, Regulatory Coordination Division
5900 Capital Gateway Drive, Mail Stop #2140
Camp Springs, MD 20588-0009
Do not mail your completed Form I-134A to this address.
OMB No. 1615-0157
Expires: 07/31/2023

https://www.dhs.gov/topics/privacy

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 2.11 hours
per response, including the time for reviewing instructions, gathering the required documentation and
information, completing the declaration, preparing statements, attaching necessary documentation, and
submitting the declaration. 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
Office of Policy and Strategy, Regulatory Coordination Division
5900 Capital Gateway Drive, Mail Stop #2140
Camp Springs, MD 20588-0009
Do not mail your completed Form I-134A to this address.
OMB No. 1615-0157
Expires: 07/31/2023

Security Reminder

If you do not work on your declaration for more than 30 days, we will delete your data in order to prevent storing personal information indefinitely.

Start

Overview

GETTING STARTED: I-134A

Column Header Descriptions
Primary Navigation: A section of the form that contains several pages.
Secondary Navigation: A single page within a section.
Conditional Logic: Indicates whether the question or subquestion only applies if you meet certain criteria.
Primary Nav

Secondary Nav

Getting Started

Basis for filing

Tertiary Nav

Conditional Logic

Paper Form
Question
1.1
1.2

[If "Parole Process"
selected in 1.2]

1.3

[If "Family Reunification 1.3
Program" selected in
1.2]

Preparer and
interpreter
information

Preparer information

Question

On whose behalf are you filing this
Another individual who is the beneficiary
form?
I am filing this form under one of the Parole Process
following:

Family Reunification Parole Process
I am filing for an individual under the Cuba
parole process for the following
Haiti
country:
Nicaragua
Ukraine
Venezuela
I am filing for my relative who is
Colombia
associated with an approved I-130
Cuba
and a national of:
El Salvador
Guatemala
Haiti
Honduras

Revision

Field Type

Another individual who is the beneficiary

Radio

Parole Process

Radio

Radio
Dropdown

Colombia
Cuba
Ecuador
El Salvador
Guatemala
Haiti
Honduras

Instructional Text

Revisions

Help Text

Select "Parole Process" for the Uniting for Ukraine and
CHNV parole processes. Select "Family Reunification
Parole Process" only if you have received personalized
invitation letters inviting you to participate in the Family
Reunification Parole Process.

Dropdown

[If "Family Reunification 1.5
Program" selected in
1.2]

How many total family members will
be included in this family reunification
group who all share the same
invitation number?
Is someone assisting you with
Yes/No
completing this declaration?

Text

(IF YES)

Is a preparer assisting you with
completing this declaration?

Yes/No

Radio

(IF YES)

Is an interpreter assisting you with
completing this declaration?

Yes/No

Radio

7.1

What is your preparer's full name?

Given name (first name)

Text

Family name (last name)
7.2

What is your preparer's business or
organization name?

Text
Text

My preparer is not part of a business or
organization.
Country

Checkbox

Address line 1
Address line 2
City or town
State/Province

Text
Text
Text
Dropdown/ Text

Street number and name
Apartment, suite, unit, or floor

ZIP code/Postal code

Text

Provide a 5 or 9-digit ZIP code.

Daytime telephone number

Text

Provide a 10-digit phone number.

Mobile telephone number

Text

Provide a 10-digit phone number.

My preparer does not have a mobile
telephone number.
Email address
My preparer does not have an email address.

Checkbox
Text
Checkbox

Given name (first name)

Text

Family name (last name)

Text
Text

My interpreter is not part of a business or
organization.
Country

Checkbox

Address line 1
Address line 2
City or town
State/Province

Text
Text
Text
Dropdown/Text

Street number and name
Apartment, suite, unit, or floor

ZIP code

Text

Provide a 5 or 9-digit ZIP code.

Daytime telephone number

Text

Provide a 10-digit phone number.

Mobile telephone number

Text

Provide a 10-digit phone number.

My interpreter does not have a mobile
telephone number
Email address
My interpreter does not have an email
address.

Checkbox

(If non-USA use Province
and text field)
(If non-USA use Postal
code and remove help
text)
7.4
7.5

What is your preparer's contact
information?

7.6

(IF YES TO INTERPRETER) 6.1

6.2

6.3

What is your interpreter's full name?

What is your interpreter's business or
organization name?

What is your interpreter's mailing
address?

(If non-USA use Province
and text field)
(If non-USA use Postal
code and remove help
text)
6.4
6.5

What is your interpreter's contact
information?

6.6

What language is your interpreter
using to interpret this declaration for
you?

Notes

Yes

For online filing, this is the only
option available

Yes

Text

What is your preparer's mailing
address?

Required?

Yes

Invitation Number:

(IF YES TO PREPARER)

Alert

Yes

[If "Family Reunification 1.4
Program" selected in
1.2]

7.3

Interpreter
information

Sub-Question

The Invitation Number can be found on the I-130
The Invitation Number can be found on
beneficiary's Family Reunification Parole Process Invitation the Form I-130 beneficiary's Family
Reunification Parole Process Invitation
Letter.
Letter.
Entering "1" indicates no derivative beneficiaries share the
same invitation number.

Yes

Radio

A preparer is anyone who completes or helps you
complete all or part of your declaration using information
and answers that you provide.
An interpreter is anyone who translates or helps you
translate all or part of your declaration using information
and answers that you provide.

Dropdown

Example: [email protected]

Dropdown

Text
Checkbox

Example: [email protected]

Text

Getting Started

ABOUT THE INDIVIDUAL AGREEING TO FINANCIALLY SUPPORT THE BENEFICIARY: I-134A

Secondary Nav

About the Individual
Agreeing to Financially
Support the Beneficiary

Name of the
individual agreeing to
financially support the
beneficiary

Tertiary Nav

Conditional Logic

Paper Form Question

Question

3.1

What is your current legal name?

Field Type

Instructional Text

Given name (first name)

Text

Your current legal name is the name on your
birth certificate, unless it changed after birth
by a legal action such as marriage or court
order. Do not provide any nicknames here.

Middle name
Family name (last name)
Yes/No

Text
Text
Radio

Have you used any other names since birth?

[If yes to 3.2]

Given name (first name)

Text

[If "Parole Process" selected in 1.2]

3.3

Middle name
Family name (last name)
Organization, Group, Individual Name

Text
Text
Text

[If "Family Reunification Parole
Process" selected in 1.2]

3.3

3.2

Contact information
for the individual
agreeing to financially
support the
beneficiary

5.3

Provide the name of the organization, group, or individual
that is providing support to the beneficiary with you (if any).
Provide the name of the individual(s) or co-sponsor(s) that is
providing support to the beneficiary with you (if any).

How may we contact you?

5.4
5.5
3.4
3.4

[If NO]

When and where the
individual agreeing to
financially support the
beneficiary was born

Immigration
information for the
individual agreeing to
financially support the
beneficiary

3.4
3.4
3.4
3.4
3.4
3.5
3.6

What is your current mailing address?

Is your mailing address the same as the physical address?
What is your physical address?

3.7

What is your date of birth?

3.9
3.9
3.9
3.8

What is your city or town of birth?
What is your state or province of birth?
What is your country of birth?
What is your sex?

3.14

What is your current immigration status?

[If Other]
3.14
[If Nonimmigrant]
3.14
(if Lawful Permanent Resident, then A- 3.1
Number is required)

What is your Form I-94 Arrival-Departure Record Number?
What is your A-Number?

3.12

What is your Social Security Number?

3.11

What is your USCIS Online Account Number?

Revisions

Provide the name of the individual co-supporter(s)
joining you to provide financial support to the
beneficiary (if any).

Sub-Question

Individual(s) or Co-sponsor(s) Name

Revisions

Individual Co-supporter(s) Name(s)

Help Text

Text

Provide a 10-digit phone number.

Mobile telephone number (if any)
This is the same as my daytime telephone number.
Email address
In care of name (if any)
Country

Text
Checkbox
Text
Text
Dropdown

Provide a 10-digit phone number.

Address line 1
Address line 2
City or town
State
ZIP code
Yes/No
In care of name (if any)
Country

Text
Text
Text
Dropdown
Text
Radio
Text
Dropdown

Street number and name
Apartment, suite, unit, or floor

Address line 1
Address line 2
City or town
State
ZIP code
MM/DD/YYYY

Text
Text
Text
Dropdown
Text
Date

Street number and name
Apartment, suite, unit, or floor

A-

I do not have or know my A-Number.
I do not have a U.S. Social Security number.

Notes

Table
Add another name button

Text

U.S. Citizen
U.S. National
Lawful Permanent Resident
Nonimmigrant
Other
Please provide an explanation.

Required?

Other names used may include aliases,
maiden name, and nicknames.
Provide the other names you have used.

Daytime telephone number

Male
Female
X

Alert

Text
Text
Dropdown
Radio

Example: [email protected]
[yellow alert]
[b] You must be located in the
United States in order to file at
this time.

Provide a 5 or 9-digit ZIP code.

[yellow alert]
[b] You must be located in the
United States in order to file at
this time.

Provide a 5 or 9-digit ZIP code.

Please select the sex that is shown on your
passport or other government-issued
identity document. For any value other than
“Male” (“M”) or “Female” (“F”) that appears
on your identity document, please choose
"X” (Unspecified or another gender identity).
USCIS requires this information to conduct
accurate background checks and security
screening.

Yes

Radio

Textbox
Text
Text

Checkbox
Text
Checkbox
Text

Provide an 11 character I-94 Number.
Provide a 7, 8, or 9-digit number. If your ANumber is fewer than 9 digits, the system
will automatically add zero(s) after the "A"
and before the first digit so there is a total of
9 digits, for example: A-001234567.

A-Number is
required if
Lawful
Permanent
Resident is
selected.

Provide a 9-digit Social Security number.
You will only have an OAN if you previously Provide a 12-digit Online Account Number.
filed a form that has a receipt number that
begins with IOE. If you filed the form online,
you can find your OAN in your account
profile. If you mailed us the form, you can
find your OAN at the top of the Account
Access Notice we sent you.
If you do not have receipt number that
begins with IOE, you do not have an OAN.
(The OAN is not the same as an A-Number.)

3.13
3.15

Employment
information for the
individual agreeing to
financially support the
beneficiary

[If Other]
[If EMPLOYED to 3.15]
[If EMPLOYED to 3.15]
[IF EMPLOYER IS NOT SELF]
[IF EMPLOYER IS NOT SELF]
[IF EMPLOYER IS SELF]

(If non-USA use Province and text
field)
(If non-USA use Postal code and
remove help text)

3.15
3.16
3.16
3.16A
3.16A
3.16B
3.17

What is your relationship to the beneficiary?
What is your employment status?

Please provide an explanation.
What is your type of employment?
Employed as
Name of employer
Self-employed as
What is your current employer's address?

I do not have or know my USCIS Online Account Number.

Checkbox

Employed (full-time, part-time, seasonal, self-employed)

Dropdown
Radio

Unemployed or not employed
Retired
Other

Country
Address line 1
Address line 2
City or town
State/Province

Radio
Radio
Radio
Textbox
Radio
Radio
Text
Text
Text
Dropdown
Text
Text
Text
Dropdown/Text

ZIP code/Postal code

Text

I am currently employed as a/an
I am currently self-employed as a/an

Yes

Street number and name
Apartment, suite, unit, or floor

Provide a 5 or 9-digit ZIP code.

About the IATFSTB

FINANCIAL INFORMATION ABOUT THE PERSON AGREEING TO FINANCIALLY SUPPORT THE BENEFICIARY: I-134A

Secondary Nav

Financial Information
About the Individual
Agreeing to Financially
Support the Beneficiary

Income information
for the individual
agreeing to
financially support
the beneficiary

Tertiary Nav

Conditional Logic

Paper Form Question

3.18
3.18

3.18

Specific
contributions to the
beneficiary

Field Type

Add entry
What is the individual's full name?

What is the individual's date of birth?
What is the individual's relationship to the individual agreeing to
financially support the beneficiary?

How much income will this individual contribute to the
beneficiary annually?
Save entry
Cancel
What is the total number of dependents?

Given name (first name)
Middle name
Family name (last name)
MM/DD/YYYY

CTA
Text
Text
Text
Date
Dropdown

I'm entering my own financial information
$

Checkbox
Text

Instructional Text

Help Text

Alert

Required?

Notes

What is the total income?
Does any of the income listed come from an illegal activity or
source (such as proceeds from illegal gambling or illegal drug
sales)?

$
Yes/No

Text
Radio

[If YES to 3.19]

3.21
3.22

Text
Radio

[IF YES TO 3.20]

3.23
3.27

What amount of income comes from an illegal activity?
$
Does any of the income listed above come from means-tested
Yes/No
public benefits as defined in 8 CFR 213a.1?
What amount of income is from means-tested public benefits?
$
You are responsible for receiving, maintaining, and supporting
the beneficiary for the duration of their temporary stay in the
United States. Describe the resources you plan to use or provide
to ensure the beneficiary has adequate financial support to cover
their basic living needs.
You are responsible for ensuring the beneficiary has safe and
appropriate housing for the duration of their parole in the United
States. Describe how you will ensure that the beneficiary's
housing needs are met, including where the beneficiary will
reside during their temporary stay in the United States, if known.
You are responsible for assisting the beneficiary's access to
available services and benefits such as learning English, securing
employment opportunities once authorized to work, enrolling
children in school, and helping to enroll for benefits for which
they are eligible. Describe what steps you plan to take as part of
these responsibilities.

3.29

Assets of the
individual agreeing
to financially
support the
beneficiary

3.23 [LARGE TABLE]

Add entry
What is the asset holder's full name?

What is the type of asset?

3.23
3.24

[If YES to 3.24,
conditional "Financial
responsibility for other
beneficiaries" section
displays]
[red alert] [If no entries
are entered and 3.24 is
yes]

3.25, 3.26 [LARGE TABLE]

If the income contribution is none, type in "0".

Provide the total number of dependents.
Number must be between 0 and 100.

Yes

Text box

Yes

Text box

Yes

Provide information about any assets you will use to support
the beneficiary for the anticipated period of his or her stay.
List only assets that can be converted into cash within 12
months and that will be used to support the beneficiary while
the beneficiary is in the United States. Provide the value of all
assets listed in U.S. dollars, regardless of whether they are
held in the United States or outside of the United States. Do
not include assets from any individuals in the “Beneficiary’s
Financial Information” section.

Given name (first name)
Middle name
Family name (last name)
Checking - Bank Account
Savings - Bank Account
Annuities
Stocks, Bonds, Certificates of Deposit
Retirement or Educational Account
Real Estate Holdings
Personal Property (net value)
$

CTA

Add entry

CTA

Given name (first name)
Middle name
Family name (last name)
A-

You may also include your household members’ assets below.
Attach evidence in the "Evidence" section under "Proof of
assets" and "Bonds" showing that you, or your dependents,
have these assets.

Dropdown

Text
CTA
CTA
Text
Radio

What is the person's A-number?

"If you are the individual agreeing to financially support the
beneficiary, type in "Self"" instructions TBD based on
feedback from Adi.

Text
Text box

What is the cash value in U.S. dollars?
Save entry
Cancel
What is the total amount (U.S. dollars)?
$
Have you previously submitted a Form I-134 or a Form I-134A on Yes/No
behalf of a person other than the beneficiary listed on this Form I134A?

What is the person's name?

Information about assets that are not based on employment
should be added in the "Assets of the individual agreeing to
financially support the beneficiary" section below.

CTA
CTA
Text

3.18
3.20

3.28

Financial
responsibility for
other beneficiaries

Sub-Question

Provide all of the information requested in the table below
about yourself, all of your dependents, and any other
individuals you financially support. Do not include any
individuals listed in the "Beneficiary's Financial Information"
section.

3.18 [LARGE TABLE]

Additional income
information for the
individual agreeing
to financially
support the
beneficiary

Question

Provide the information about the people for whom you have
previously submitted a Form I-134 or Form I-134A, other than
the beneficiary listed on this Form I-134A.

Text
Text
Text
Text

[red alert]
You must include at least one person for
whom you have previously submitted a
Form I-134 or Form I-134A, other than
the beneficiary listed on this Form I-134A.

Provide a 7, 8, or 9-digit number. If your ANumber is fewer than 9 digits, the system will
automatically add zero(s) after the "A" and
before the first digit so there is a total of 9
digits, for example: A-001234567.

Financial Info ATIATFSTP

FINANCIAL INFORMATION ABOUT THE PERSON AGREEING TO FINANCIALLY SUPPORT THE BENEFICIARY: I-134A

Secondary Nav

Tertiary Nav

Conditional Logic

Paper Form Question

Question

Sub-Question

Field Type

Instructional Text

Help Text

Alert

Required?

Notes

I do not have or know the person's A-Number. Checkbox
Date submitted

MM/DD/YYYY

Date

Financial Info ATIATFSTP

ABOUT THE BENEFICIARY: I-134A

Secondary Nav

About the Beneficiary

Beneficiary name

Tertiary Nav

Conditional Logic

Revision

Paper Form Question

Question

Sub-Question

Field Type

Instructional Text

2.1

What is the beneficiary's current
legal name?

Given name (first name)

Text

The beneficiary's current legal name is the name
on their birth certificate, unless it changed after
birth by a legal action such as marriage or court
order. Do not provide any nicknames here.

Middle name
Family name (last name)
Yes/No

Text
Text
Radio

Given name (first name)

Text

Middle name
Family name (last name)
Yes/No

Text
Text
Radio

2.1
2.1
2.2
[If yes to 2.2]

[If "Family Reunification
Program" selected in
1.2]
Beneficiary contact
information

2.13
2.14

Has the beneficiary used any other
names since birth?
[LIST]

Is this the individual listed as the
principal beneficiary in your Family
Reunification Parole Process
invitation letter?
Daytime telephone number
How may we contact the
beneficiary?
Mobile telephone number (if any)
This is the same as the beneficiary's
daytime telephone number.

Help Text

Revision

Alert

Revision

Required?

Other names used may include aliases, maiden
name, and nicknames.
Provide the other names the beneficiary has used.

Notes

Table
Add another name button

Yes

Text

Provide a 10 to 20-digit number.

Text
Checkbox

Provide a 10 to 20-digit number.

[blue alert]
[b] You must provide a valid email address for the beneficiary. If your Form I-134A is
confirmed, we will send important information to the beneficiary at this email address. If
you do not provide an email address that the beneficiary can access, they will not be able
to complete the parole process. DO NOT enter your email address in this field.
2.15
[If selected "Family
Reunification Parole
Process" in 1.2," show
United States in
dropdown]

[If United States
mailing address,
default to 'No']
[If no]

2.10

2.10
2.10
2.10
2.10
2.10
2.10
2.11

2.12

[If selected "Family
Reunification Parole
Process" in 1.2," show
instructional text]
2.12
2.12
2.12
2.12
2.12
2.3

When and where
beneficiary was born

2.6
2.6
2.6

Other Information
about the
Benefiiciary

[If OTHER]
[If selected "Parole
Process" in 1.2, show
yellow alert]

What is the beneficiary's current
mailing address?

Is the beneficiary's mailing address
the same as the physical address?
What is the beneficiary's physical
address?

What is the beneficiary's date of
birth?
What is the beneficiary's city or
town of birth?
What is the beneficiary's state or
province of birth?
What is the beneficiary's country of
birth?
A grant of parole is a discretionary
determination granted on a case-bycase basis for urgent humanitarian
reasons or significant public benefit.
Please explain why a favorable
exercise of discretion is merited for
this individual.

Email address
Confirm the beneficiary's email address
In care of name (if any)

Text
Text
Text

Country
Address line 1
Address line 2
City or town
Province
Postal code
Yes/No

Dropdown
Text
Text
Text
Dropdown/Text
Text
Radio

In care of name (if any)

Text

Country
Address line 1
Address line 2
City or town
Province
Postal code
MM/DD/YYYY

Dropdown
Text
Text
Text
Dropdown/Text
Text
Date

Yes

The beneficiary's physical address must be outside
of the United States.

Instructional text conditional based on selection of
FRP in 1.2

Street number and name
Apartment, suite, unit, or floor

Yes

Text
Dropdown/Text
Text Box

What is the beneficiary's sex?

Male
Female
X

Radio

2.9

What is the beneficiary's marital
status?

Single, Never Married
Married
Divorced
Widowed
Legally Separated
Marriage Annulled
Other

Radio

Provide an explanation

Text box
Dropdown

What is the beneficiary's country of
citizenship or nationality?

Yes
Street number and name
Apartment, suite, unit, or floor

Text

2.4

2.9
2.7

Example: [email protected]
Example: [email protected]

Yes

Please select the sex that is shown on your
passport or other government-issued identity
document. For any value other than “Male” (“M”)
or “Female” (“F”) that appears on your identity
document, please choose “X” (Unspecified or
another gender identity). USCIS requires this
information to conduct accurate background
checks and security screening.

Yes

[If selected "Family
Reunification Parole
Process" in 1.2 show
yellow alert]

Note: Individuals only eligible as immediate family members and children under age 18
must travel with their beneficiary spouse, common law partner, parent, or legal guardian
to be eligible for parole.
[yellow alert]
[h] We are only accepting online filing of Form I-134A from individuals agreeing to
financially support Cuban, Colombian, Haitian, Honduran, Salvadoran, and Guatamalan
citizens and their immediate family

[yellow alert]
[h] We are only accepting online filing of Form I-134A from individuals agreeing to
financially support Cuban, Colombian, Haitian, Honduran, Ecuadorian, Salvadoran, and
Guatamalan citizens and their immediate family

[b] Immediate family members are:

• Their spouse or common-law partner; and
• Unmarried children under the age of 21.

• The spouse or common-law partner of the primary beneficiary who is a citizen of a
qualifying country; and
• Unmarried children under the age of 21.

Note: Individuals only eligible as immediate family members and children under age 18
must travel with their beneficiary spouse, common law partner, parent, or legal guardian to Note: Individuals only eligible as immediate family members and children under age 18
be eligible for parole.
must travel with their beneficiary spouse, common law partner, parent, or legal guardian to
be eligible for parole.
[If selected "Parole
Process" in 1.2, show
yellow alert]

2.8

What country issued the
beneficiary's most recently issued
passport?

Dropdown

[yellow alert]
[h] We are only accepting online filing of Form I-134A from individuals agreeing to
financially support Cuban, Haitian, Nicaraguan, Ukrainian, and Venezuelan citizens and
their immediate family
[b] Immediate family members are:
• Their spouse or common-law partner; and
• Unmarried children under the age of 21.
Note: Individuals only eligible as immediate family members and children under age 18
must travel with their beneficiary spouse, common law partner, parent, or legal guardian to
be eligible for parole.

[If selected "Family
Reunification Parole
Process" in 1.2 show
yellow alert]

[yellow alert]
[h] We are only accepting online filing of Form I-134A from individuals agreeing to
financially support Cuban, Colombian, Haitian, Honduran, Salvadoran, and Guatamalan
citizens and their immediate family

[b] Immediate family members are:

• Their spouse or common-law partner; and
• Unmarried children under the age of 21.

• The spouse or common-law partner of the primary beneficiary who is a citizen of a
qualifying country; and
• Unmarried children under the age of 21.

Note: Individuals only eligible as immediate family members and children under age 18
must travel with their beneficiary spouse, common law partner, parent, or legal guardian to Note: Individuals only eligible as immediate family members and children under age 18
be eligible for parole.
must travel with their beneficiary spouse, common law partner, parent, or legal guardian to
be eligible for parole.
2.8

(if Cuban)
(If Haitian)

What is the number of the
beneficiary's most recently issued
passport?

Text

Provide a 7 to 12-character passport number.

Provide a 7-character passport number,
beginning with 1 letter followed by 6 digits.
Provide a 9-character passport number,
beginning with 1-3 letters followed by 6-8
digits.

About the Beneficiary

ABOUT THE BENEFICIARY: I-134A

Secondary Nav

Tertiary Nav

Conditional Logic

Revision

Paper Form Question

Question

Sub-Question

Field Type

Instructional Text

(if Nicaraguan)

Help Text

Alert

Revision

Required?

Notes

Provide a 8 to 9-character passport number,
beginning with 1 letter followed by 7-8 digits.
Provide an 8-character passport number,
beginning with 2 letters followed by 6 digits.
Provide a 9-digit passport number.
Provide an 8-character passport number,
beginning with 2 letters followed by 6 digits.
Provide a 7 to 8-character passport number,
beginning with 1 letter followed by 6-7 digits.

(if Ukrainian)
(if Venezuelan)
(if Colombia)
(if Honduras
(if Ecuador)

Provide a 9-character passport number,
beginning with 1 letter followed by 8 digits.

(if El Salvador)

Provide a 9-character passport number,
beginning with 1 letter followed by 8 digits.
Provide a 9-digit passport number.
Provide a 9-digit passport number.

(if Guatemala)
(if Russian)
(if Venezuelan is most
recent passport show
tooltip)

Revision

2.8
2.8

What is the expiration date of the
beneficiary's most recently issued
passport?

Confirm the beneficiary's passport number
MM/DD/YYYY
Date

Expiration Date (MM/DD/YYYY)

Note: The beneficiary must have a valid,
unexpired passport. CBP will not approve
travel if the beneficiary's passport is
expired.

Tooltip only shows if Venezuelan is selected for
country that issued the beneficiary's most recent
passport:
If the beneficiary has received a passport extension,
then enter the extension’s expiration date. For more
information visit the Process for Venezuelans
webpage.
Link: https://www.uscis.gov/CHNV

2.5

2.16

What is the beneficiary's A-Number? A-

Text

I do not have or know the beneficiary's ANumber.
What is the beneficiary's anticipated From (MM/DD/YYYY)
period of stay in the United States?
To (MM/DD/YYYY)
No End Date

Checkbox

Date
Date
Checkbox

About the Beneficiary

BENEFICIARY'S FINANCIAL INFORMATION: I-134A

Secondary Nav

Beneficiary's Financial
Information

Beneficiary income
information

Tertiary Nav

Conditional Logic

Paper Form Question

Question

Sub-Question

Field Type

Instructional Text

Help Text

Alert

Required?

Notes

Provide information about the income of the beneficiary, all of the beneficiary's dependents, and any other individuals the beneficiary
financially supports. Do not include any individuals named in the "Financial Information About the Individual Agreeing to Financially
Support the Beneficiary" section.
Add entry

CTA

Opens up large table once clicked
Provide all of the information requested in the table below about the beneficiary, all of the beneficiary's dependents, and any other
individuals the beneficiary financially supports (do not include information about the individual agreeing to financially support the
beneficiary). Information about assets that are not based on employment should not be included here but may be added under
"Beneficiary Assets" below.

2.17 [LARGE TABLE]

What is the individual's full name?

Given name (first name)
Middle name
Family name (last name)
MM/DD/YYYY

What is individual's date of birth?
What is the individual's relationship to the
beneficiary?
How much income will this individual
$
contribute to the beneficiary annually?
Save entry
Cancel

Beneficiary
additional income
information

Text

2.17

How much income will the beneficiary's
$
dependents contribute to the beneficiary
annually?
Does any of the beneficiary's total income Yes/No
(including income from dependents and
other individuals who contribute to the
beneficiary's income, excluding any
individuals named in the "Financial
Information About the Person Agreeing to
Financially Support the Beneficiary"
section) come from an illegal activity or
source (such as proceeds from illegal
gambling or illegal drug sales)?

Text

What amount of the beneficiary's total
$
income comes from an illegal activity or
source?
Does any of the beneficiary's total income Yes/No
come from means-tested public benefits as
defined in 8 CFR 213a.1?
What amount of the beneficiary's total
$
income comes from means-tested public
benefits?

Text

2.19

2.21

If the income contribution is none, type in "0".

CTA
CTA

What is the beneficiary's total number of
dependents?

2.20

[If YES to 2.20]

Text

2.17

2.18

[If YES to 2.18]

Text
Text
Text
Date
Dropdown

Provide the total number of
dependents. Number must be
between 0 and 100.

Radio

Text

Beneficiary assets

Provide the current cash value of any assets available to the beneficiary for the expected period of his or her stay. List only assets that
can be converted to cash within 12 months and that will be used to support the beneficiary while the beneficiary is in the United States.
Provide the value of all assets listed in U.S. dollars, regardless of whether the assets are held in the United States or outside of the United
States. Do not include assets from any individuals named in the "Financial Information About the Individual Agreeing to Financially
Support the Beneficiary" section.
You may include the net value of the beneficiary’s home as an asset. The net value of the home is the appraised value of the home, minus
the sum of all loans secured by a mortgage, trust deed, or other lien on the home. If you list the net value of the beneficiary’s home, then
you must include documentation demonstrating that the beneficiary owns the home, a recent appraisal by a licensed appraiser, and
evidence of the amount of all loans secured by a mortgage, trust deed, or other lien on the home.
You may not include the net value of the beneficiary’s automobile unless the beneficiary has more than one automobile, and at least one
automobile is not included as an asset. Submit evidence of the value of the assets listed. Evidence must include the name of the asset
holder, a description of the asset, proof of ownership, and the basis for the owner’s claim of its net cash value.
Attach evidence in the "Evidence" section under "Proof of beneficiary’s assets" and "Bonds" showing that the beneficiary has these
assets.
2.22 [LARGE TABLE]

Add entry
What is the asset holder's full name?

Given name (first name)
Middle name
Family name (last name)
What is the type of asset?
Checking - Bank Account
Savings - Bank Account
Annuities
Stocks, Bonds, Certificates of Deposit
Retirement or Educational Account
Real Estate Holdings
Personal Property (net value)
What is the cash value of the asset in U.S. $
dollars?
Save entry
Cancel
What is the total amount (U.S. dollars)?
$

CTA
Text
Text
Text
Dropdown

Text
CTA
CTA
Text

Beneficiary's Financial Info

EVIDENCE: I-134A

Column Header Descriptions
Primary Navigation: A section of the form that contains several pages.
Primary Nav
Evidence

Secondary Nav
Bank officer
statement

Tertiary Nav

Conditional Logic

Paper Form

Evidence Title

Field Type

Form I-134 instructions (pg 5) Bank Officer Statement

Upload

Employer
statement

Form I-134 instructions (pg 5) Employer Statement

Upload

Income tax return

Form I-134 instructions (pg 6) Income Tax Return

Upload

Bonds

Form I-134 instructions (pg 6) Bonds

Upload

Proof of
immigration
status

Form I-134 instructions (pg 5 Proof Of Immigration
Item #10: Immigration Status) Status

Upload

Proof of assets of
individual
agreeing to
financially
support the
beneficiary

Form I-134 instructions (pg 5 Proof Of Assets Of
Item #19: Assets
Individual Agreeing To
Financially Support The
Beneficiary

Upload

Instructional Text

Provide a statement from an officer of the bank or other financial institutions with deposits, identifying the following details:

Document type

Bank officer
statement
Other documents

File Requirements

• Clear and readable
• Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
• Date account opened
• No encrypted or password-protected files
• Total amount deposited for the past year; and
• If your documents are in a foreign language, upload a full English
• Present balance.
translation and the translator's certification with each original
document.
As the person who agrees to financially support the beneficiary, you must show you have sufficient income or financial resources
• Upload no more than five documents at a time
to support the beneficiary. Failure to provide evidence of sufficient income or financial resources may result in the denial of the
• Accepted file name characters: English letters, numbers, spaces,
foreign national's application for a visa or his or her removal from the United States.
periods, hyphens, underscores, and parentheses
• Maximum size: 12MB per file
Provide statement(s) from your employer on business stationery showing:
Employer
• Clear and readable
statement
• Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
Other documents • No encrypted or password-protected files
• Date and nature of employment
• If your documents are in a foreign language, upload a full English
• Salary paid; and
translation and the translator's certification with each original
• Whether the position is temporary or permanent.
document.
• Upload no more than five documents at a time
As the person who agrees to financially support the beneficiary, you must show you have sufficient income or financial resources
• Accepted file name characters: English letters, numbers, spaces,
to support the beneficiary. Failure to provide evidence of sufficient income or financial resources may result in the denial of the
periods, hyphens, underscores, and parentheses
foreign national's application for a visa or his or her removal from the United States.
• Maximum size: 12MB per file
Provide a copy of the last U.S. federal income tax return filed (tax transcript).
Income tax return • Clear and readable
Other documents • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
As the person who agrees to financially support the beneficiary, you must show you have sufficient income or financial resources
• No encrypted or password-protected files
to support the beneficiary. Failure to provide evidence of sufficient income or financial resources may result in the denial of the
• If your documents are in a foreign language, upload a full English
foreign national's application for a visa or his or her removal from the United States.
translation and the translator's certification with each original
document.
• Upload no more than five documents at a time
• Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
• Maximum size: 12MB per file
Provide a list containing serial numbers and denominations of bonds and name of record owner(s).
Bonds
• Clear and readable
Other documents • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
• No encrypted or password-protected files
As the person who agrees to financially support the beneficiary, you must show you have sufficient income or financial resources
• If your documents are in a foreign language, upload a full English
to support the beneficiary. Failure to provide evidence of sufficient income or financial resources may result in the denial of the
translation and the translator's certification with each original
foreign national's application for a visa or his or her removal from the United States.
document.
• Upload no more than five documents at a time
• Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
• Maximum size: 12MB per file
Provide evidence of your status.
Immigration status • Clear and readable
Other documents • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
A U.S. citizen or U.S. national may submit a copy of a birth certificate, certificate of naturalization, certificate of citizenship,
• No encrypted or password-protected files
consular report of birth abroad to U.S. parents, or a copy of the biographic data page on your U.S. passport.
• If your documents are in a foreign language, upload a full English
translation and the translator's certification with each original
Proof of lawful permanent resident status includes a photocopy of both sides of the Permanent Resident Card or Alien
document.
Registration Receipt Card (Form I-551), or a photocopy of an unexpired temporary Form I-551 stamp in either a foreign passport
• Upload no more than five documents at a time
or DHS Form I-94 Arrival Departure Record.
• Accepted file name characters: English letters, numbers, spaces,
periods, hyphens, underscores, and parentheses
Proof of lawful nonimmigrant status may include a copy of an unexpired visa in a foreign passport.
• Maximum size: 12MB per file
Provide information about any assets you will use to support the beneficiary for the anticipated period of his or her stay. List only Assets
• Clear and readable
assets that can be converted into cash within 12 months and that will be used to support the beneficiary while the beneficiary is Other documents • Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
in the United States. Provide the value of all assets listed in U.S. dollars, regardless of whether they are held in the United States
• No encrypted or password-protected files
or outside of the United States. Do not include assets from any individuals in the “Beneficiary’s Financial Information” section.
• If your documents are in a foreign language, upload a full English
translation and the translator's certification with each original
You may include the net value of a home as an asset. The net value of the home is the appraised value of the home, minus the
document.
sum of all loans secured by a mortgage, trust deed, or other lien on the home. If you include the net value of your home, then
• Upload no more than five documents at a time
you must include documentation demonstrating that you own the home, a recent appraisal by a licensed appraiser, and evidence
• Accepted file name characters: English letters, numbers, spaces,
of the amount of all loans secured by a mortgage, trust deed, or other lien on the home.
periods, hyphens, underscores, and parentheses
• Maximum size: 12MB per file
You may not include the net value of an automobile unless you show that you have more than one automobile, and at least one
automobile is not included as an asset.

Alerts

Required?

Links Notes

Submit evidence of the value of your or your household members’ assets. Evidence must include the name of the asset holder, a
description of the asset, proof of ownership, and the basis for the owner’s claim of its net cash value.

Proof of
beneficiary's
assets

Form I-134 instructions (pg 4 Proof Of Beneficiary's
Item #22: Beneficiary's Assets Assets

Upload

As the person who agrees to financially support the beneficiary, you must show you have sufficient income or financial resources
to support the beneficiary. Failure to provide evidence of sufficient income or financial resources may result in the denial of the
foreign national's application for a visa or his or her removal from the United States.
Provide information about any assets available to the beneficiary for the anticipated period of his or her stay. List only assets that Beneficiary asset
can be converted into cash within 12 months and that will be used to support the beneficiary while the beneficiary is in the United Other documents
States. Provide the value of all assets listed in U.S. dollars, regardless of whether the assets are held in the United States or
outside the United States. Do not include assets from any individuals in the “Financial Information About the Person Agreeing to
Financially Support the Beneficiary” section.
You may include the net value of the beneficiary’s home as an asset. The net value of the home is the appraised value of the
home, minus the sum of all loans secured by a mortgage, trust deed, or other lien on the home. If you list the net value of the
beneficiary’s home, then you must include documentation demonstrating that the beneficiary owns the home, a recent appraisal
by a licensed appraiser, and evidence of the amount of all loans secured by a mortgage, trust deed, or other lien on the home.

You may not include the net value of the beneficiary’s automobile unless the beneficiary has more than one automobile, and at
least one automobile is not included as an asset. Submit evidence of the value of the assets listed. Evidence must include the
name of the asset holder, a description of the asset, proof of ownership, and the basis of the owner’s claim of its net cash value.
You may submit evidence of the value of the beneficiary's household members’ assets. Evidence must include the name of the
asset holder, a description of the asset, proof of ownership, and the basis for the owner’s claim of its net cash value.

Proof of the
beneficiary's marital
status

[If "Family Reunification Parole
Process" selected in 1.2 AND if user
did NOT select "Single, Never Married"
in 2.9]

Proof Of Beneficiary's Marital Upload
Status

Proof of the
beneficiary's family
relationship

[If "Family Reunification Parole Process"
selected in 1.2]

Proof Of Beneficiary's Family Upload
Relationship

Provide evidence of the beneficiary’s age and family relationship with the principal beneficiary of an approved Form I-130.
If the beneficiary is the principal beneficiary of an approved Form I-130, only evidence of the beneficiary’s age is required.

Birth certificate
Adoption decree

• Clear and readable
• Accepted file formats: JPG, JPEG, PDF, TIF or TIFF
• No encrypted or password-protected files
• If your documents are in a foreign language, upload a full English
translation and the translator's certification with each original document.
• Upload no more than five documents at a time
• Accepted file name characters: English letters, numbers, spaces, periods,
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• No encrypted or password-protected files
• If your documents are in a foreign language, upload a full English
translation and the translator's certification with each original document.
• Upload no more than five documents at a time
• Accepted file name characters: English letters, numbers, spaces, periods,
hyphens, underscores, and parentheses
• Maximum size: 12MB per file

Evidence

ADDITIONAL INFORMATION: I-134A

Column Header Descriptions
Primary Navigation: A section of the form that contains several pages.
Secondary Navigation: A single page within a section.
Paper Form Question: The number in the paper form associated with the question
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Secondary Nav

Additional Information

Additional
Information

Tertiary Nav

Conditional Logic

Paper Form Question

Question

Sub-Question

Field Type

Instructional Text

Large table

If you need to provide any additional information for any of your answers to the questions
in this form, enter it into the space below. You should include the questions that you are
referencing.
If you do not need to provide any additional information, you may leave this section blank.

Help Text

Alert

Required?

Notes

Large Table
Pattern
Ghost Sub
Nav

Additional Information

REVIEW AND SUBMIT: I-134A

Column Header Descriptions
Primary Navigation: A section of the form that contains several pages.
Secondary Navigation: A single page within a section.
C di i
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d i di
h h h
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Secondary Nav
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Review and Submit

i
l
li if
Conditional Logic

i
i i
Paper form question

Review your declaration

Question

Sub-Question

Field Type

Check your declaration before you submit

Instructional Text

Help Text

Alert

Required?

CTA

Notes

Please review your declaration and check it for accuracy and completeness before you submit it.
We encourage you to provide as many responses as you can throughout the declaration. Missing
or incomplete information may slow down the review process after you submit your declaration.
You can return to this page to review your declaration as many times as you want before you
submit it.

[blue alert]
[Alert appears only for drafts
started before toggle on of I134A ~12/21]

[blue alert header for active drafts]
[h] The name of this form has changed

Alert appears only for drafts started before
toggle on of I-134A ~12/21

[b] The name of this form has changed to Form I-134A, Online Request to be a Supporter and
Declaration of Financial Support.

https://www.uscis.gov/i-134a

No other changes have been made to your draft. Learn more about Form I-134A.
Your fee

Your form filing fee is: $[xxx]
Refund policy: USCIS does not refund fees, regardless of any action we take on your application, petition or request, or how long USCIS takes to reach a decision. By continuing this
transaction, you acknowledge that you must submit fees in the exact amount and that you are paying the fees for a government service.

Alerts and warnings

You have one or more alerts and warnings based on the information you provided in your
declaration.

A red alert means you have incomplete responses or inconsistent data. You cannot submit your
declaration with any alerts.
Green alert: We found no alerts or warnings in your declaration.
Your declaration summary

Review the I-134A form information

Here is a summary of all the information you provided in your declaration.

Make sure you have provided responses for everything that applies to you before you submit
your declaration. You can edit your responses by going to each declaration section using the site
navigation.
We also prepared a draft case snapshot with your responses, which you can download below.
Preparer statement

(IF PREPARER)

7.7

Preparer's statement

I am not an attorney or accredited representative but have prepared this declaration on behalf of the individual agreeing to financially support the beneficiary and with that
individual's consent.

Radio

Your preparer must read the statements below and select the statement that applies to him or
her.
If your preparer is an attorney or accredited representative whose representation extends
beyond preparation of this declaration, he or she may be obliged to submit a completed Notice
of Entry of Appearance as Attorney or Accredited Representative (G-28) with your declaration.

Preparer's certification and signature

I am an attorney or accredited representative and my representation of the individual agreeing to financially support the beneficiary in this case does not extend beyond the
Radio
preparation of this declaration.
I am an attorney or accredited representative and my representation of the individual agreeing to financially support the beneficiary in this case extends beyond the preparation of Radio
this declaration.
By my signature, I certify, under penalty of perjury, that I prepared this declaration at the request of the individual agreeing to financially support the beneficiary (which is the
beneficiary if on behalf of him or herself). The individual agreeing to financially support the beneficiary then reviewed this completed declaration and informed me that he or she
understands all of the information contained in, and submitted with, his or her declaration, including the Certification of the Individual Agreeing to Financially Support the
Beneficiary, and that all of this information is complete, true, and correct. I completed this declaration based only on filing information that the individual agreeing to financially
support the beneficiary provided to me or authorized me to obtain or use.

Your preparer must read and agree to the certification below.

As the declarant's preparer, you must sign on paper and provide your signature page to the declarant. Follow these steps:

1. Download the Preparer Signature page
2. Print the Preparer Signature page
3. Read and sign the Preparer Signature page
4. Give the signed Preparer Signature page to the declarant
The declarant will need to scan and upload your completed signature page on the next screen.
Preparer signature
Interpreter certification

(IF PREPARER)
(IF INTERPRETER)

7.8
6.7

Preparer's Signature Upload
Interpreter's certification and signature

Upload
I certify, under penalty of perjury, that: I am fluent in English and the language provided in the Getting Started section of this declaration, and I have read to this individual agreeing
to financially support the beneficiary in the identified language every question and instruction on this declaration and his or her answer to every question. The individual agreeing
to financially support the beneficiary informed me that they understand every instruction, question, and answer on the declaration, including the Certification of the Individual
Agreeing to Financially Support the Beneficiary, and has verified the accuracy of every answer.
As the declarant's interpreter, you must sign on paper and provide your signature page to the declarant. Follow these steps:

Scan and upload your preparer's completed signature page below.
Your interpreter must read and agree to the certification below.

1. Download the Interpreter Signature page
2. Print the Interpreter Signature page
3. Read and sign the Interpreter Signature page
4. Give the signed Interpreter Signature page to the declarant
The declarant will need to scan and upload your completed signature page on the next screen.
Interpreter signature

(IF INTERPRETER)

Statement of the individual
agreeing to financially
support the beneficiary

(IF NO INTERPRETER)

5.1.A

Individual agreeing to financially support the
beneficiary's statement

I can read and understand English, and have read and understand every question and instruction on this declaration and my answer to every question.

Checkbox

Scan and upload your interpreter's completed signature page below.
I, as the individual agreeing to financially support the beneficiary, certify the following:
You must read and agree to the statement below.

(IF PREPARER)

5.2

At my request, the preparer named in the Getting Started section of this declaration prepared this declaration for me based only upon the information I provided or authorized.

Checkbox

You must read and agree to the statement below.

(IF INTERPRETER)

5.1.B

You must read and agree to the statement below.

5.6

The interpreter named in the Getting Started section of this declaration read to me every question and instruction on this declaration and my answer to every question in the
language I specified in the Getting Started section, a language in which I am fluent, and I understood everything.
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 and all of my records that USCIS or
the Department of State may need to determine my eligibility for the immigration benefit I seek.

Checkbox

(If "Statement of the
Individual agreeing to
financially support the
beneficiary" is complete)

Individual agreeing to financially support the
beneficiary's statement regarding the preparer
Individual agreeing to financially support the
beneficiary's statement regarding the interpreter
Individual agreeing to financially support the
beneficiary's Certification

Signature of the individual
agreeing to financially
support the beneficiary

Interpreter's Signature Upload

Upload

Next
MVP

MVP
Next

MVP

You must read and agree to the certification below. If you knowingly and willfully falsify or
conceal a material fact or submit a false document with your declaration, we can deny your
declaration and may deny any other immigration benefit. You may also face criminal prosecution
and penalties provided by the law.

I further authorize release of information contained in this declaration, 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 declaration;
2. I understood all of the information contained in, and submitted with, my declaration; 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 declaration, I understand all of the information contained in, and submitted with, my
declaration, and that all of this information is complete, true, and correct.
That this declaration is made by me to assure the U.S. Government that the beneficiary named under the About Beneficiary section will be financially supported while in the United
States.
That I am willing and able to receive, maintain, and support the person named under the About Beneficiary section to better ensure that such persons will have sufficient financial
resources or financial support to pay for necessary expenses for the period of his or her temporary stay in the United States.
I acknowledge that I have read this section, and I am aware of my responsibilities as an individual agreeing to financially support the beneficiary.
I have read and agree to the statement and certification of the individual agreeing to financially support the beneficiary
Individual Agreeing to Financially Support the
Beneficiary's Signature

Submit

(Successful submission) (No
nav)

(If "Statement of the
Individual agreeing to
financially support the
beneficiary" and "Signature
of Individual Agreeing to
Financially Support the
Beneficiary's Signature" are
complete)

Submit the I-134A

You have successfully submitted your Online Request
to be a Supporter and Declaration of Financial Support
(I-134A)

Checkbox
Text

You must provide your digital signature below by typing your full legal name. If you do not
completely fill out this declaration, or if you do not submit the required documents listed in the
Instructions, we may deny your declaration. We will record the date of your signature with your
declaration.
Once you submit this declaration, you will receive a confirmation with details on any next steps.
We will record the date of your submission with the declaration. Your case status will be updated
on your home page.

We will contact you if we have any questions or need additional information. You can track the
status of your declaration through your USCIS online account.

Yes

Submit the I-134A

Go to my cases

Review & Submit

WARNINGS, ALERTS, NOTICES, AND ERRORS: I-134A

Column Header Descriptions
Section: The primary nav where the alert can be found.
Page: The secondary nav where the alert can be found.
Type: The color of the alert. (Red, Yellow, Blue, Green)
Conditional Logic: A column used to indicate whether the question or subquestion only applies if you meet certain criteria.
Message: The copy that will show on the alert Use [h] to indicate the header copy and [b] to indicate the body copy
Navigation
Sub-navigation
Type
Conditional Logic
File-A-Form
Overview

Yellow alert

Always show

Message

Revision

Link

[h] We are only accepting online filing of Form I-134A from individuals agreeing to financially support eligible beneficiaries from the following countries:

https://www.uscis.gov/i-134

[b]
• Cuba
• Colombia
• El Salvador
• Guatemala
• Haiti
• Honduras
• Nicaragua
• Ukraine
• Venezuela

[b]
• Cuba
• Colombia
• Ecuador
• El Salvador
• Guatemala
• Haiti
• Honduras
• Nicaragua
• Ukraine
• Venezuela

You must be located in the United States to file Form I-134A online. Individuals seeking parole through these processes may not file Form I-134A on their own behalf. Supporters must
include the name of the beneficiary on Form I-134A.
Supporters must file a separate Form I-134A for each beneficiary they are planning to support, including minor children.
To be eligible for this process, children under the age of 18 must be traveling to the United States in the care and custody of their parent or legal guardian and be able to provide
documentation to confirm the relationship.
If you are agreeing to support a beneficiary who is not seeking consideration for parole under one of these programs or processes, you must file a paper Form I-134 through the
appropriate Lockbox location.
About the IATFSTB

Contact information for the individual agreeing Yellow alert
to financially support the beneficiary

About the IATFSTB

When and where the individual agreeing to
financially support the beneficiary was born

About the IATFSTB

Immigration information for the individual
agreeing to financially support the beneficiary

Red alert

You must be located in the United States to file Form I-134A online. Individuals seeking parole through these processes may not file Form I-134A on their own behalf. Supporters must
include the name of the beneficiary on Form I-134A.
Supporters must file a separate Form I-134A for each beneficiary they are planning to support, including minor children.
To be eligible for this process, children under the age of 18 must be traveling to the United States in the care and custody of their parent or legal guardian and be able to provide
documentation to confirm the relationship.
If you are agreeing to support a beneficiary who is not seeking consideration for parole under one of these programs or processes, you must file a paper Form I-134 through the
appropriate Lockbox location.

Always show under "What is your current mailing
[b] You must be located in the United States in order to file at this time.
address?" question and "What is your physical
address?" question
If date of birth is different than the date of birth of the h5. This account has already been verified with a different date of birth
applicant's profile, the following red alert is shown.
The date of birth in this account's profile is [MM/DD/YYYY].

If A-Number is different than the A-Number of the
applicant's profile, the following red alert is shown.

Notes

https://myaccount.uscis.gov/

If you need to apply for a benefit for someone else using the date of birth you entered, you should sign out of this account and create a new account for them at
https://myaccount.uscis.gov/
h5. This account has already been verified with a different A-Number

https://myaccount.uscis.gov/

The A-Number in this account's profile is [xxxxxxxxx].
If you need to apply for a benefit for someone else using the A-Number you entered, you must sign out of this account and create a new account for them at
https://myaccount.uscis.gov/

Financial Info
Financial responsibility for other beneficiaries
ATIATFSTP
About the Beneficiary Beneficiary contact information

Red alert

If no entries are entered and 3.24 is yes

You must include at least one person for whom you have previously submitted a Form I-134 or Form I-134A, other than the beneficiary listed on this Form I-134A.

Blue alert

Always show

About the Beneficiary Other information about the beneficiary

Yellow alert

[b] You must provide a valid email address for the beneficiary. We will send them important information at this email address if Form I-134A is confirmed. If you do not provide an email
address that the beneficiary can access, they will not be able to complete the parole process. DO NOT enter your email address in this field.
[h] We are only accepting online filing of Form I-134A from individuals agreeing to financially support Cuban, Haitian, Nicaraguan, Ukrainian, and Venezuelan citizens and their
immediate family

if user selected "Parole Process" in question 1.2,
show under "What is the beneficiary's country of
citizenship or nationality?" question and "What country
issued the beneficiary's most recently issued passport?" [b] Immediate family members are:
question
• Their spouse or common-law partner; and
• Unmarried children under the age of 21.

About the Beneficiary Other information about the beneficiary

Review & Submit

Review your declaration

Yellow alert

Blue alert

Note: Individuals only eligible as immediate family members and children under age 18 must travel with their beneficiary spouse, common law partner, parent, or legal guardian
to be eligible for parole.
[yellow alert]
If user selected "Family Reunification Parole Process" [yellow alert]
in question 1.2, show under "What is the beneficiary's [h] We are only accepting online filing of Form I-134A from individuals agreeing to financially support Cuban, Colombian, Haitian, Honduran, Salvadoran, and Guatamalan citizens [h] We are only accepting online filing of Form I-134A from individuals agreeing to financially support Cuban, Colombian, Haitian, Honduran, Ecuadorian, Salvadoran, and Guatamalan
citizens and their immediate family
country of citizenship or nationality?" question and
and their immediate family
"What country issued the beneficiary's most recently
[b] Immediate family members are:
issued passport?" question
[b] Immediate family members are:
• Their spouse or common-law partner; and
• Unmarried children under the age of 21.

• Their spouse or common-law partner of the primary beneficiary who is a citizen of a qualifying country; and
• Unmarried children under the age of 21.

Alert appears only for active drafts started before toggle [h] The name of this form has changed
on of I-134A ~12/21
[b] The name of this form has changed to Form I-134A, Online Request to be a Supporter and Declaration of Financial Support.

https://www.uscis.gov/i-134a

No other changes have been made to your draft. Learn more about Form I-134A.

Alerts

File Type	application/pdf
File Title	Copy of I-130 Form Copydeck 6.18.19- acaOCC 062719
Author	Microsoft Office User
File Modified	2023-10-20
File Created	2023-10-20