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-006_EMGREV_Copydeck

OMB: 1615-0157

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I-134A, Online Request to be a Supporter and Declaration of Financial Support
1615-0157

I-134A-xxx

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be removed in the revision column with the words on
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2. Bananas
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1. Oranges
2. Bananas

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I want to go hiking today.

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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

Field Type

File a Form

Select the form you want to file online

[dropdown]

Body Text

Revision

Select the form you want to file online. Once you start, we will automatically save your
information for 30 days, or from the last time you worked on the form.

Fee waiver: If you are requesting a fee waiver, you cannot file online. You must file a paper
version of both the Form I-912, Request for Fee Waiver and the form for the specific benefit you
are requesting. You can review the fee waiver guidance at www.uscis.gov/feewaiver.

Fee waiver: If the form you want to file is eligible for a fee waiver, and you would like to request
one, you must file by paper. You must file a paper version of both the Form I-912, Request for Fee
Waiver and the form for the specific benefit you are requesting. You can review the fee waiver
guidance at www.uscis.gov/feewaiver.

Alert

Link

[Conditionally displayed when Form I-134A is selected from the drop down]
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 I134A for the duration of the beneficiary’s stay in the United States.

CTA

Notes

Start form

[yellow alert]
https://www.uscis.gov/i-134
[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
• 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.
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.

File-A-Form

APPLICATION OVERVIEW: I-134A

Column Header Descriptions
Heading: The primary heading on a page, typically the first part of a section of the page.
Sub-Heading: The secondary header, typically directly underneath the Heading.
Primary Navigation: A section of the form that contains several pages.
Secondary Navigation: A single page within a section.
Body Text: Based on the questions from the paper form.
Link: A reference column to include any URLs that appear as hyperlinks in the Instructional text.
Heading

Sub-Heading

Conditional Logic

I-134A, Online Request To Be
A Supporter And Declaration
Of Financial Support
[yellow alert]

Body Text

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

[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:

Required?

Link

CTA

Notes

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 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.
Before You Start Your
Declaration

Eligibility

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.
We will automatically calculate the cost for you before you submit your request. For
specific information about fees applicable to this form, see Form G-1055.

Fee

Documents you may need

As the beneficiary's financial supporter, you must show you have sufficient income or financial resources to support the beneficiary.

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.
Please refer to the instructions for the form(s) you are filing for additional

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.
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.

Biometric services
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
Respond to requests for
information
Receive your decision

Completing Your Form
Online

Provide your biometrics

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
USCIS Compliance Review
and Monitoring

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
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.

We will contact you to schedule an appointment at an Application Support Center near you. At the appointment, we will get your fingerprints, photograph, and signature.

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.
By signing this form, you have stated under penalty of perjury (28 U.S.C. section 1746) that all information and documentation submitted with this form is true and
correct. You have also authorized the release of any information from your records that USCIS may need to determine eligibility for the benefit you are seeking and
consented to USCIS’ verification of such information.
The Department of Homeland Security has the legal authority to verify any information you submit to establish eligibility for the immigration benefit you are seeking at
any time. USCIS’s legal authority to verify this information is in 8 U.S.C. Sections 1103, 1154, 1155, and 1357, and 8 CFR Parts 103, 204, 245, and 287. To ensure
compliance with applicable laws and authorities, USCIS may verify information before or after your case has been decided. Agency verification methods may include,
but are not limited to: review of public records and information; contact via written correspondence, the Internet, facsimile, or other electronic transmission, or
telephone; unannounced physical site inspections of residences and places of employment; and interviews. Information obtained through verification will be used to
assess your compliance with the laws and to determine your eligibility for the benefit sought.
Subject to the restrictions under 8 CFR section 103.2(b) (16), you will be provided an opportunity to address any adverse or derogatory information that may result
from a USCIS compliance review, verification, or site visit after a formal decision is made on your case or after the agency has initiated an adverse action that may
result in revocation or termination of an approval.

DHS Privacy Notice

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 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-134 is seeking
and to conduct background investigations on supporters and co-supporters (if applicable) for law enforcement and national security purposes
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, DHS/USCIS-010 Asylum Information and Pre-Screening System of Records, and DHS/USCIS018 Immigration Biometric and Background Check, 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(a) USCIS Electronic Immigration System, DHS/USCIS/POIA-057
National Appointment Scheduling System (NASS), DHS/USCIS/PIA-060 Customer Profile Management System (CPMS), DHS/USCIS/PIA-071 myUSCIS Account Experience,
DHS/USCIS/PIA-079 Content Management Services (CMS), and U.S. Customs and Border Protection (CBP) DHS/CBP/PIA-073 Advance Travel Authorization (ATA), DHS/CBP/PIA-024
Arrival and Departure Information System and DHS/CBP/PIA-068 CBP One Mobile Application], 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.
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, result in denial of the beneficiary’s benefit request, or prevent DHS from conducting and adjudicating a background investigation.

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.
FBI Privacy Notice

Paperwork Reduction Act

Security Reminder

https://www.dhs.gov/topics/p
rivacy

USCIS may use your biometrics to obtain the criminal history records of the FBI, for identity verification, to determine eligibility, to create immigration documents (for example,
Permanent Resident Card, Employment Authorization Document), or any purpose authorized by the Immigration and Nationality Act. You may obtain a copy of your own FBI record
using the procedures outlined at 28 CFR 16.30-16.34. Learn how to obtain a copy of your FBI record or how the FBI will use your fingerprints.

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 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 2.6011 hours per response, including the time for
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
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: submitting the declaration. The collection of biometrics is estimated to require 1 hour and 10 minutes. 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
U.S. Citizenship and Immigration Services
Office of Policy and Strategy, Regulatory Coordination Division
Office of Policy and Strategy, Regulatory Coordination Division
5900 Capital Gateway Drive, Mail Stop #2140
5900 Capital Gateway Drive, Mail Stop #2140
Camp Springs, MD 20588-0009
Camp Springs, MD 20588-0009
Do not mail your completed Form I-134A to this address.
Do not mail your completed Form I-134A to this address.
OMB No. 1615-0157
OMB No. 1615-0157
Expires: 07/31/2023
Expires: 07/31/2023
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.
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.
C diti
l L i I di t
h th th
ti
b
ti
l
Primary Nav

Secondary Nav

Getting Started

Basis for filing

Tertiary Nav

Conditional Logic

t i

it i

Revisions

Paper Form
Question
1.1
1.2

[If "Parole Process"
selected in 1.2]

1.3

Question

Revisions

On whose behalf are you filing this
form?
I am filing this form under one of the
following:

I am filing for an individual under the
parole process for the following
country:

[If "Parole Process"
selected]

Sub-Question

Revisions

Field Type

Another individual who is the beneficiary

Radio

Parole Process

Radio

Family Reunification Parole Process
Cuba
Haiti
Nicaragua
Ukraine
Venezuela

Radio
Dropdown

Who is providing financial support for the
beneficiary?

I am the only individual providing financial
support

Revisions

Instructional Text

Help Text

Alert

Required?
Yes

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.

Yes

Revisions

Notes

For online filing, this is the only
option available

Yes

Dropdown

I am the primary supporter providing
financial support along with other
individuals who are also providing financial
support
I am a co-supporter providing financial
support along with a primary supporter
I am filing as an individual providing
financial support along with an organization
I am filing on behalf of an organization that
will provide all of the financial support

Preparer and
interpreter
information

Preparer information

[If "Family Reunification
Program" selected in
1.2]

1.3

I am filing for my relative who is
associated with an approved I-130
and a national of:

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

1.4

Invitation Number:

Text

1.5

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
completing this declaration?

Text

Yes

Dropdown

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

Yes

Yes/No

Radio

(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
My preparer does not have a mobile
telephone number.
Email address
My preparer does not have an email
address.
Given name (first name)

Text
Checkbox

Provide a 10-digit phone number.

Text
Checkbox

Example: [email protected]

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

Text
Checkbox

Provide a 10-digit phone number.

Text
Checkbox

Example: [email protected]

(IF YES TO PREPARER)

7.3

What is your preparer's mailing
address?

(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

Interpreter
information

Colombia
Cuba
Ecuador
El Salvador
Guatemala
Haiti
Honduras

(IF YES TO
INTERPRETER)

6.1

What is your interpreter's full name?

6.2

What is your interpreter's business or
organization name?

6.3

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?

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

Text

Dropdown

Text

Getting Started

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

Column Header Descriptions
Primary Nav

Secondary Nav

About the Individual
Agreeing to Financially
Support the Beneficiary

Name of the
individual agreeing to
financially support the
beneficiary

Secondary Nav

Tertiary Nav Conditional Logic

Conditional Logic

Paper Form Question

Question

[If filing as an individual providing
support with an organization]

Sub-Question

Text

3.2

Have you used any other names since birth?

Middle name
Family name (last name)
Yes/No

Text
Text
Radio

3.3

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

Given name (first name)
Middle name
Family name (last name)
Provide the name of the organization that is providing support Organization, Group, Individual Name
to the beneficiary with you.
Provide the name of the organization that you are filing on
behalf of.

Organization name

[If filing on behalf of or with an
organization]
[If filing on behalf of or with an
organization]
[If filing on behalf of or with an
organization]
[If filing on behalf of or with an
organization]
[If filing on behalf of or with an
organization]
[If filing on behalf of or with an
organization]

Is this organization a sole proprietorship?

Yes
No

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

5.3

34
34
34
34
34
35
3.6

[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
[If U.S. National, Nonimmigrant, or
Other.
If Nonimmigrant, then number must
be provided]

3.14

What is your current immigration status?

3 14
3.14

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

3.1

What is your A-Number?

[If U.S. Citizen, U.S. National,
Nonimmigrant, or Other]
[Displayed to all regardless of
immigration status selection]
[Displayed to all regardless of
immigration status selection]

3.12

What is your Social Security Number?

3.11

What is your USCIS Online Account Number?

3 13
3.15

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

3 15
3 16
3 16
3 16A
3 16A
3 16B
3 17

Please provide an explanation
What is your type of employment?

Notes

Modified

Y/N
New

New

New
New

FIEN
ITIN
SSN

Radio

New

Enter the Number

Text

New

Accounting/Doll
ar
Text

Add this amount to your income amount in Financial Information.

New
Given name (first name)

Text

Middle name

Text

Family name (last name)

Text

New

Add another name

CTA
Text

New
New

If you are a co-supporter you must provide the receipt number that
the primary supporter received from USCIS after the submission of
their Form I-134A

Individual Co-supporter(s) Name(s)

Text

Daytime telephone number

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)

Text
Text
Text
Dropdown
Text
Radio
Text

Street number and name
Apartment suite unit or floor

Country

Dropdown

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

Text
Text
Text
Dropdown
Text
Date

Text
Text
Dropdown
Radio

Male
Female
X

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

[If U.S. National or Other]
[Displayed to all regardless of
immigration status selection.
If Lawful Permanent Resident, then
number must be provided.]

Required?

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

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?

Required?

Text

What is your current mailing address?

What is your date of birth?

Alert

Text

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

39
39
39
3.8

Alert

Text

What is the primary supporter's Form I-134A receipt number?

3.7

Help Text

Text

54
55
34
3.4

Help Text

What is the organization's website?

How many additional people are supporting the beneficiary
with you?
Provide the name(s) of the co-supporter(s) joining you to
provide financial support to the beneficiary.

3.3

Instructional Text

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

Text
Text
Text
Text

Enter the dollar amount that the organization is providing.

3.XX

Instructional 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.

What is the organization's email address?

Provide the organization's taxypayer identification number.
This may be a Federal Employer Identification Number (FEIN),
Individual IRS Tax Number (ITIN), or U.S. Social Security
Number (SSN).

[If filing as co-supporter]

Field Type

What is the organization's phone number?

What is the organization's address?

[If filing on behalf of or with an
organization]
[If filing as primary along with other
individuals]
[If filing as primary along with other
individuals]
[If filing as primary along with other
individuals]
[If filing as primary along with other
individuals]
[If filing as primary along with other
individuals]

(if Lawful Permanent Resident, then
A-Number is required)

Organization name

[If filing on behalf of an organization]

Contact information
for the individual
agreeing to financially
support the
beneficiary

Field Type

Given name (first name)

[If filing on behalf of or with an
organization]

[If Other]
[If Nonimmigrant]

Sub-Question

What is your current legal name?

[If yes to 3 2]
[If "Parole Process" selected in 1.2]

Question

3.1

Example: user@domain com
[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

Street number and name
Apartment suite unit or floor

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

Y
Y
Y
Y
Y
Y
Conditional if
3.5 is "No"

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

Textbox
Text

If CBP admitted you into the United States at a land, airport or seaport Provide an 11 character I-94 Number.
after April 30, 2013, they may have issued you an electronic Form I-94
instead of a paper Form I-94. You may visit the CBP website at
https://i94.cbp.dhs.gov/I94/#/home to obtain your electronic Form I94. CBP does not charge a fee for this service. For certain Classes of
Admissions and in specific circumstances, your electronic I-94 will not
be available through the website. If you cannot obtain your Form I-94
from the CBP website, you may obtain it by filing Form I-102,
Application for Replacement/Initial Nonimmigrant Arrival-Departure
Record, with USCIS. USCIS does charge a fee for Form I-102. See Form
G-1055, available at www.uscis.gov/forms, for specific information
about the fees applicable to this form.

I do not have an I-94 Record Number or do not know my I94 Record Number.

Y
Text

I do not have or know my A-Number.

I do not have an A-Number or do not know my ANumber.

I do not have a U.S. Social Security number.

I do not have a SSN, I do not know my SSN, or I am opting Checkbox
not to provide my SSN.
Text

What is your Social Security Number (SSN)?

New

Y
Y

Radio

A-

New

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.

Checkbox

Text

Provide a 9-digit Social Security number.

Y
Y

You will only have an OAN if you previously
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.

Provide a 12-digit Online Account Number.

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

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)

Employed as
Name of employer
Self-employed as
What is your current employer's address?

Employed (full-time, part-time, seasonal, selfemployed)

Unemployed or not employed
Retired
Other

Checkbox
Dropdown
Radio

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

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

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

Question

Sub-Question

Field Type

Instructional Text

Help Text

Alert

Required?

Notes

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.
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.
3.18 [LARGE TABLE]

3.18
3.18

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?

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

Checkbox
Text

3.18
3.20

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
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.

Text
Radio

[IF YES TO 3.20]

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.

3.18

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

Specific
contributions to the
beneficiary

3.28

3.29

"If you are the individual agreeing to financially support the
beneficiary, type in "Self"" instructions TBD based on feedback
from Adi.
If the income contribution is none, type in "0".

CTA
CTA
Text

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

Text
Text box

Yes

Text box

Yes

Text box

Yes

Assets of the
individual agreeing
to financially support
the beneficiary

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.
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.
3.23 [LARGE TABLE]

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

What is the type of asset?

3.23
3.24

Financial
responsibility for
other beneficiaries

CTA
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)
$

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?

Dropdown

Text
CTA
CTA
Text
Radio

[If YES to 3.24,
conditional "Financial
responsibility for other
beneficiaries" section
displays]

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.

Add entry

CTA
[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.

[red alert] [If no entries
are entered and 3.24 is
yes]

3.25, 3.26 [LARGE TABLE]

What is the person's name?

What is the person's A-number?

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

Text
Text
Text
Text

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

Date submitted

Sub-Question

Field Type

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

Checkbox

MM/DD/YYYY

Date

Instructional Text

Help Text

Alert

Required?

Notes

Financial Info ATIATFSTP

ABOUT THE BENEFICIARY: I-134A

Secondary Nav

About the Beneficiary

Beneficiary name

Tertiary Nav

Conditional Logic

Paper Form Question

Question

2.1

What is the beneficiary's current legal Given name (first name)
name?

2.1
2.1
2.2
[If yes to 2.2]

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

2.13

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

2.15
2.10

2.10
2.10
2.10
2.10
2.10
2.10
[If United States mailing 2.11
address, default to 'No']
[If no]

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

2.4

2.9

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

2.9
2.7

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 country of
citizenship or nationality?

Instructional Text

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.

Text
Text
Radio

Given name (first name)

Text

Middle name
Family name (last name)
Yes/No

Text
Text
Radio

Help Text

Required?

Notes

Table
Add another name button

Yes

Text

Provide a 10 to 20-digit number.
Provide a 10 to 20-digit number.

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

Text
Text
Text

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

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

Single, Never Married
Married
Divorced
Widowed
Legally Separated
Marriage Annulled
Other
Provide an explanation

Alert

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

Mobile telephone number (if any)
Text
This is the same as the beneficiary's daytime Checkbox
telephone number.

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.
What is the beneficiary's sex?
Male
Female
X

What is the beneficiary's marital
status?

Field Type

Middle name
Family name (last name)
Yes/No

Is this the individual listed as the
principal beneficiary in your Family
Reunification Parole Process
invitation letter?
How may we contact the beneficiary? Daytime telephone number

2.14

[If selected "Family
Reunification Parole
Process" in 1.2," show
United States in
dropdown]

Sub-Question

[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.

Yes
Street number and name
Apartment, suite, unit, or floor
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
Text
Dropdown/Text
Text Box

Radio

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

Radio

Text box
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.

About the Beneficiary

ABOUT THE BENEFICIARY: I-134A

Secondary Nav

Tertiary Nav

Conditional Logic

Paper Form Question

Question

Sub-Question

Field Type

Instructional Text

Help Text

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

Alert

Required?

Notes

[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:
• 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 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]

(if Cuban)

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

(if Nicaraguan)
(if Ukrainian)
(if Venezuelan)
(if Colombia)
(if Honduras
(if Ecuador)
(if El Salvador)
(if Guatemala)
(if Russian)
(if Venezuelan is most
recent passport show
tooltip)

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

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

2.16

What is the beneficiary's anticipated
period of stay in the United States?

Text

I do not have or know the beneficiary's ANumber.
From (MM/DD/YYYY)

Checkbox

To (MM/DD/YYYY)
No End Date

Date
Checkbox

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.

Date

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

Add entry

Field Type

CTA

Instructional Text

Help Text

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.

Alert

Required?

Notes

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?

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

What is the beneficiary's total number of
dependents?

Text

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

2.17

2.20

[If YES to 2.20]

Text
Text
Text
Date
Dropdown

2.17

2.18

[If YES to 2.18]

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

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?

What is the type of asset?

What is the cash value of the asset in U.S.
dollars?
Save entry
Cancel
What is the total amount (U.S. dollars)?

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
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

Secondary Nav

Tertiary Nav

Conditional Logic

Paper Form

Form I-134 instructions (pg 5)

Paper Form

Update Form number (I-134A)

Evidence Title

Bank Officer Statement

Evidence Title

Field Type
Upload

Field Type

Instructional Text

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

Instructional Text

• Date account opened
• Total amount deposited for the past year; and
• Present balance.

Employer statement

Form I-134 instructions (pg 5)

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 statement(s) from your employer on business stationery showing:

Upload

Employer Statement

• Date and nature of employment
• Salary paid; and
• Whether the position is temporary or permanent.

Document type

Bank officer
statement
Other documents

Document type

Form I-134 instructions (pg 6)

Income Tax Return

Upload

Provide a copy of the last U.S. federal income tax return filed (tax transcript).
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.

Bonds

Form I-134 instructions (pg 6)

Bonds

Upload

Provide a list containing serial numbers and denominations of bonds and name of record owner(s).

Income tax return
Other documents

• 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,
hyphens, underscores, and parentheses
• Maximum size: 12MB per file
• 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,
hyphens, underscores, and parentheses
• Maximum size: 12MB per file
• 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,
hyphens, underscores, and parentheses
• Maximum size: 12MB per file

Bonds
Other documents

Proof of immigration
status

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

Proof Of Immigration Status

Upload

Provide evidence of your status.

Immigration status
Other documents

A U.S. citizen or U.S. national may submit a copy of a birth certificate, certificate of naturalization, certificate of citizenship, consular report of
birth abroad to U.S. parents, or a copy of the biographic data page on your U.S. passport.
Proof of lawful permanent resident status includes a photocopy of both sides of the Permanent Resident Card or Alien Registration Receipt Card
(Form I-551), or a photocopy of an unexpired temporary Form I-551 stamp in either a foreign passport or DHS Form I-94 Arrival Departure
Record.
Proof of lawful nonimmigrant status may include a copy of an unexpired visa in a foreign passport.

Proof of assets of
individual agreeing
to financially
support the
beneficiary

Form I-134 instructions (pg 5 Item
#19: Assets

Proof Of Assets Of Individual
Agreeing To Financially
Support The Beneficiary

Upload

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.

Employer statement
Other documents

File Requirements

Assets
Other documents

Beneficiary asset
Other documents

Marriage certificate
Divorce decree
Annulment decree
Death certificate

Birth certificate
Adoption decree

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 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 you must include documentation
demonstrating that you own 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.

File Requirements

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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.
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.
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.
Proof of
beneficiary's assets

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

Proof Of Beneficiary's Assets

Upload

Provide information about any assets available to 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 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.
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.

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
Status

Upload

Proof of the
beneficiary's family
relationship

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

Proof Of Beneficiary's Family
Relationship

Upload

Provide evidence of the beneficiary’s marital status.
If the beneficiary is married or has had a change in marital status since submission of the USCIS Form I-130, submit a copy of the beneficiary’s
current marriage certificate and any divorce decree, annulment decree, or death certificate showing that their prior marriages were
terminated (if applicable).

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.

Proof of Supporter
Identity

[If "Parole Process" selected in Getting
Started]

Proof of the Supporter's
Identity

Upload

Proof of the
beneficiary's
Identity

[If "Parole Process" selected in Getting
Started]

Proof of the Beneficiary's
Identity

Upload

Organization
Evidence

[If "Parole Process" and filing with or on
behalf of an organization selected in
Getting Started]

Organization's Confirmation
of Support

Organization
Evidence

[If "Parole Process" and filing with or on
behalf of an organization selected in
Getting Started]

Organization's Financial
Information

Photo Identity Document
You must upload a copy of an official photo identity document showing your photo, name, and date of birth. For example:
A valid government-issued driver's license;
Passport identity page;
Any national identity document from your country of origin bearing
your photo;
Any school-issued form of identification with photo; or
Any other official identity document with a photo.
Note: The copy must clearly show the photo and identity information.
Passport Photo
You must upload a copy of an official passport identity page showing the beneficiary's photo, name, and date of birth.
Note: The copy must clearly show the photo and identity information.

Photo Identity
Document

Upload

You must upload a copy of the organization's commitment of financial support for the beneficiary.

Letter/Statement

Upload

You must upload evidence that shows the organization has sufficient income or financial resources to support the beneficiary.

Financial
Other documents

Photo Identity
Document

New

Evidence

ADDITIONAL INFORMATION: I-134A

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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.

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Notes

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Additional Information

REVIEW AND SUBMIT: I-134A

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Review and Submit

Review your declaration

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Check your declaration before you submit

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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.

(IF PREPARER)

Preparer statement

7.7

Preparer's statement

Preparer's certification and signature

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

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

Radio

We also prepared a draft case snapshot with your responses, which you can download below.
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.

Radio
Your preparer must read and agree to the certification below.

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

Checkbox
Text

Individual Agreeing to Financially Support the
Beneficiary's Signature

Submit

Pay and Submit

Submit the I-134A

(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)

Your form filing fee is: $[xxx]
Refund policy:
By continuing this transaction, you agree that you are paying for a government service and that the filing fee, biometric services fee and all related financial transactions are final and not
refundable, regardless of any action USCIS takes on an application, petition or request, or how long USCIS takes to reach a decision. You must submit all fees in the exact amounts.
Exact fee will be pulled from ELIS
We will send you to Pay.gov — our safe, secure payment website — to pay your fees and submit your application online.Here are the steps in the payment and submission process:
1. Provide your billing information on Pay.gov
2. Provide your credit card or U.S. bank account information
3. Submit your payment

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.

Yes

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.

Submit the I-134A Pay and Submit

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.

Go to my cases

Exact fee will be pulled from ELIS

When you have paid your fee, your application will be submitted.
(Successful submission) (No
nav)

You have successfully submitted your Online Request to
be a Supporter and Declaration of Financial Support (I134A)

Review & Submit

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

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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

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Overview

Type

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Link

Yellow alert

Always show

[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

Notes

[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

Red alert

Always show under "What is your current mailing
address?" question and "What is your physical address?"
question
If date of birth is different than the date of birth of the
applicant's profile, the following red alert is shown.

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

h5. This account has already been verified with a different date of birth

https://myaccount.uscis.gov/

The date of birth in this account's profile is [MM/DD/YYYY].
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/

About the IATFSTB

Immigration information for the individual
agreeing to financially support the beneficiary

Red alert

Financial responsibility for other beneficiaries

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.

About the Beneficiary Beneficiary contact information

Blue alert

Always show

[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.

About the Beneficiary Other information about the beneficiary

Yellow alert

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?"
question

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

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
ATIATFSTP

[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.

About the Beneficiary Other information about the beneficiary

Yellow alert

If user selected "Family Reunification 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?" question

[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:
• 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 be eligible for parole.

Alerts

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

Sub-navigation

Type

Conditional Logic

Message

Link

Review & Submit

Review your declaration

Blue alert

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

[h] The name of this form has changed

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

Notes

[b] The name of this form has changed to Form I-134A, Online Request to be a Supporter and Declaration of Financial Support.
No other changes have been made to your draft. Learn more about Form I-134A.

Alerts

File Type	application/pdf
Author	Microsoft Office User
File Modified	2024-09-20
File Created	2024-09-20