Pages 4-5, Part 2.
Information About the Alien For Whom the Bond Is Furnished
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[Page 4]
Part 2. Information About the
Alien For Whom the Bond Is Furnished
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12. Information About the
Alien’s Attorney or Accredited Representative
Is the alien represented by an
attorney or accredited representative for this Form I-945, Public
Charge Bond?
Yes
No
If you answered “Yes,”
please submit another form G-28 with this public charge bond and
provide the information requested below, even if a Form G-28 is
already on file with Form I-485, Application to Register Permanent
Residence or Adjust Status. If the attorney or accredited
representative does not submit Form G-28 for this Form I-945
public charge bond, U.S. Citizenship and Immigration Services
(USCIS) will not be able to communicate with the attorney or
accredited representative on behalf of the bonded alien.
A. Volag Number (if any)
B. Attorney State Bar Number
(if applicable)
C. Attorney or Accredited
Representative USCIS Online Account Number (if any)
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Part 2. Information About the
Applicant For Whom the Bond Is Furnished
…
[no change]
If you answered “Yes,”
please submit another Form G-28 with this public charge bond
even if a Form G-28 is already on file with Form I-485,
Application to Register Permanent Residence or Adjust Status. If
the attorney or accredited representative does not submit Form
G-28 for this Form I-945 public charge bond, U.S. Citizenship and
Immigration Services (USCIS) will not be able to communicate with
the attorney or accredited representative on behalf of the bonded
alien.
[deleted]
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Pages 7-8, Part 3.
General Terms and Conditions
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[Page 7]
Part 3. General Terms and
Conditions
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Conditions of the Bond - The
Alien Will Not Receive Public Benefits and Will Comply With Any
Other Conditions Imposed
In consideration of the granting of
the above alien’s application for adjustment of status,
providing there is a furnished suitable bond, the obligor hereby
furnishes such bond with the following conditions.
1.A. Alien Will Not Receive
Public Benefits. If the alien receives any public benefits, as
defined in 8 CFR 212.21(b), for more than 12 months in the
aggregate within any 36 month period (such that, for instance,
receipt of two benefits in one month counts as two months, after
the alien's adjustment of status and until the bond is cancelled
pursuant to 8 CFR 213.1(g), the obligor or agent/co-obligor shall
pay the entire amount of the bond as directed by DHS.
B. Alien will comply with
any other conditions imposed as part of this public charge bond,
which are:
(1) Conditions:
_______________________
(2) Mentioned in any rider
or riders lettered _____ and captioned ____.
[Page 7]
2. Substitute Bond.
A. Substitution by the Same
Obligor as the Initial Bond Posted. Any new/substitute bond
must meet all of the requirements applicable to the bond
previously submitted to USCIS on the alien’s behalf, as
outlined in 8 CFR 103.6 and 8 CFR 213.1, and must be valid and
effective on or before the day the bond on file with DHS expires.
When substituting a bond, the obligor or any agent/co-obligor
agrees and understands that the substitute bond must be completed
and submitted on this form in accordance with the directions given
in this form and this form’s instructions.
…
3. Breach. The
obligor or any agent/co-obligor agrees and understands that the
following circumstances constitute a breach of the public charge
bond:
A. The alien has received
any public benefits, as defined in 8 CFR 212.21(b), for more than
12 months in the aggregate within any 36 month period (such that,
for instance, receipt of two benefits in one month counts as two
months, after the alien’s
adjustment of status to that of a lawful permanent resident and
until the bond is cancelled pursuant to 8 CFR 213.1(g); or
B. Noncompliance with any
conditions imposed as part of this bond, as outlined in the
Conditions of the Bond - The Alien Will Not Receive Public
Benefits and Will Comply With Any Other Conditions Imposed section
in Part 4.
…
5. Cancellation of the Bond.
The obligor or any agent/co-obligor agree and understand to the
following: the obligor or any agent/co-obligor may submit a
request to cancel the bond together with a completed Form I-356,
Request for Cancellation of Public Charge Bond, according to the
form’s Instructions. The obligor and agent/co-obligor
furthermore agree and understand that the applicant may submit
Form I-356 (and evidence that the conditions of the bond have been
met) without any action by or permission from the obligor or any
agent/co-obligor.
If USCIS determines that the
information received is insufficient to determine whether
cancellation is appropriate, DHS may request additional
information before making a cancellation determination. A public
charge bond may only be cancelled in the following circumstances:
A. Death of the alien as
evidenced by a certified copy of a death certificate; permanent
departure of the alien, as defined in 8 CFR 213.1;
or naturalization of the alien, and the alien has not become a
public charge, as defined in 8 CFR 212.21(a) after the date of
DHS’ acceptance of any bond; or
[new]
B. After the fifth
anniversary of the admission of the alien, or the adjustment to
lawful permanent resident, provided that the immigrant did not
become a public charge, as defined in 8 CFR 212.21(a):
The obligor, any agent/co-obligor,
or the alien or the alien’s representative (if any) may file
a request using Form I-356, and DHS will adjudicate the request to
cancel the bond.
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Part
3. General Terms and Conditions
…
Conditions
of the Bond - The Alien Will
Comply With Any Conditions Imposed
In
consideration of the granting of the application for adjustment of
status, providing there is a furnished suitable and
proper bond, the obligor hereby furnishes such bond with
the following conditions.
[deleted]
1.
Alien will comply with any conditions imposed as part of this
public charge bond, which are:
(A)
Conditions: _______________________
(B)
Mentioned in any rider or riders lettered _____ and captioned
____.
[no change]
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3. Breach. The
obligor or any agent/co-obligor agrees and understands that the
following circumstances constitute a breach of the public charge
bond:
A.
The alien has received any means-tested
public benefit.
Noncompliance
with any conditions imposed as part of this bond, as outlined in
the Conditions of the Bond - The Alien Will
Comply With Any Conditions Imposed section in
Part 4.
…
[no change]
A. Death of the applicant as
evidenced by a certified copy of a death certificate, provided the
immigrant did not become a public charge prior to death;
B.
Permanent departure of the applicant, provided the immigrant did
not become a public charge prior to departure.
C.
Naturalization of the applicant, provided the immigrant did not
become a public charge prior to naturalization.
D.
After the fifth anniversary of the admission of the alien, or
the adjustment of status to that of a lawful permanent resident.
The
obligor, any agent/co-obligor, or the applicant or the alien’s
representative (if any) may file a request using Form I-356, and
DHS will adjudicate the request to cancel the bond.
…
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Pages 9-10, Part 4.
Obligor’s or Agent/Co-Obligor’s Statement,
Declaration, Certification, and Signature
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[Page 9]
Part 4. Obligor’s or
Agent/Co-Obligor’s Statement, Declaration, Certification,
and Signature
NOTE: Read the Penalties
section of the Form I-945 Instructions before completing this
section.
Public Charge Bond Guarantee
Statement and Certification
1. In consideration of the
facts recited in the Conditions of the Bond - The Alien Will
Not Receive Public Benefits and Will Comply With Any Other
Conditions Imposed section in Part 3. (and in any rider
or riders lettered___ and captioned ___), the obligor and the
agent/co-obligor named in Part 1. acting on the obligor’s
behalf (if any), by subscribing hereto, hereby declare that they
are firmly bound unto the United States in the sum of $___.
I (obligor and agent/co-obligor)
agree to the terms and conditions as set forth in this form and
the instructions.
The obligor and the agent/co-obligor
named in Part 1. acting on the obligor’s behalf (if
any) thereby guarantee that the alien, named in Part 2.,
will not receive any public benefits, as defined in 8 CFR
212.21(b), for more than 12 months in the aggregate within any 36
month period (such that, for instance, receipt of two benefits in
one month counts as two months, after the alien's adjustment of
status and until the bond is cancelled pursuant to 8 CFR 213.1(g).
The obligor and the agent/co-obligor acting on the obligor’s
behalf (if any), agree and understand that the amount of the bond
will be forfeited to the United States as liquidated damages and
not as a penalty upon failure to comply with the terms set forth
in bond and rider (if any). The obligor and agent/co-obligor
further agree and understand that any bond-related notice to
him/her in connection with this bond may be accomplished by mail,
directed to him/her at the above address. The obligor and any
agent/co-obligor acknowledge receipt of a copy of the executed
bond and any attached rider or riders specified above. The
obligor and any agent/co-obligor agree and understand that DHS
will send a copy of the executed bond and any attached rider or
riders specified above to the alien.
…
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Part 4. Obligor’s or
Agent/Co-Obligor’s Statement, Declaration, Certification,
and Signature
[no change]
1.
In consideration of the facts recited in the Conditions of the
Bond - The Alien Will Not Receive Any
Means-tested Public Benefits.
Comply With Any
Conditions Imposed section in Part 3. (and in any rider
or riders lettered___ and captioned ___), the obligor and the
agent/co-obligor named in Part 1. acting on the obligor’s
behalf (if any), by subscribing hereto, hereby declare that they
are firmly bound unto the United States in the sum of $___.
[no change]
The
obligor and the agent/co-obligor named in Part 1, acting on
the obligor’s behalf (if any) thereby guarantee that the
immigrant named in Part 2, will not receive any
means-tested public benefit.
The obligor and the agent/co-obligor
acting on the obligor’s behalf (if any), agree and
understand that the amount of the bond will be forfeited to the
United States as liquidated damages and not as a penalty upon
failure to comply with the terms set forth in bond and rider (if
any). The obligor and agent/co-obligor further agree and
understand that any bond-related notice to him/her in connection
with this bond may be accomplished by mail, directed to him/her at
the above address. The obligor and any agent/co-obligor
acknowledge receipt of a copy of the executed bond and any
attached rider or riders specified above. The obligor and any
agent/co-obligor agree and understand that DHS will send a copy of
the executed bond and any attached rider or riders specified above
to the alien.
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