I-356 Instructions Table of Changes

TABLE OF CHANGES –INSTRUCTIONS

Form I-356, Request for Cancellation of Public Charge Bond

OMB Number: 1615-0141

10/14/2025

Reason for Revision: Public Charge

Project Phase: FO Review

Legend for Proposed Text:

• Black font = Current text

• Red font = Changes

Expires 10/31/2021

Edition Date 10/15/2019

Current Page Number and Section	Current Text	Proposed Text
Page 1, What Is the Purpose of Form I-356?	[Page 1] What Is the Purpose of Form I-356? You should use this form to request cancellation of the public charge bond that was submitted on Form I-945, Public Charge Bond, on behalf of an alien (someone who is not a citizen of the United States).	[Page 1] What Is the Purpose of Form I-356? You should use this form to request cancellation of the public charge bond that was submitted on behalf of an alien on Form I-945, Public Charge Bond.
Page 1, Who Must Complete and File Form I-356?	[Page 1] Who Must Complete and File Form I-356? Form I-356 has several parts that must be completed either by the obligor (the person who has posted the bond) or by the obligor’s authorized agent (co-obligor, for surety companies only) who posted the bond on behalf of the alien, or by the alien. If the alien is deceased, the executor of the alien’s estate may complete the alien’s part on behalf of the alien. This form must be submitted according to the instructions provided in this form and the direct filing instructions posted on www.uscis.gov. Either the obligor (or the agent/co-obligor, if any) or the alien (or the alien’s executor or accredited representative, if any) may submit this form. The alien (or the alien’s executor, or the alien’s attorney or accredited representative, if any) may submit Form I-356 (and evidence that the conditions of the bond have been met) without the obligor or any agent/co-obligor, but USCIS encourages completion of the entire form. NOTE: The term “you” in these instructions refers to the person(s) completing this form or parts of this form, including the alien (or his or her executor or accredited representative, if any) or the obligor (or the obligor’s agent/co-obligor, if any).	[Page 1] Who Should Complete and File Form I-356? Form I-356 can be submitted to request cancellation of the public charge bond by the alien on whose behalf the public charge bond was posted, the alien’s attorney or accredited representative, if any, or, if the alien is deceased, the executor of the alien’s estate. Form I-356 can also be filed by the obligor (the person who posted the bond for the alien) or the obligor’s authorized agent (co-obligor, for surety companies only). This request must be submitted according to the instructions provided in this request and the direct filing instructions posted on www.uscis.gov. NOTE: This request does not have to be filed if a substitute bond is submitted to release an obligor from the current liability of a public charge bond posted with U.S. Citizenship and Immigration Services (USCIS) on the alien’s behalf. For more information about substitution of a public charge bond, please see Form I-945, Public Charge Bond, and its Instructions.
Page 1, How Is Form I-356 Used?	[Page 1] How Is Form I-356 Used? Public Charge Bonds (Form I-945) are posted as security under the condition that the alien will not receive 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 to that of a lawful permanent resident and during the bond’s effective period. If an alien receives 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), the bond is breached and forfeited. NOTE: This form does not have to be filed if a substitute bond is submitted to release an obligor from the current liability of a public charge bond posted with USCIS on the alien’s behalf. We will not make any breach or cancellation assessments as part of a substitution of a public charge bond currently on file with USCIS. For more information about substitution of a public charge bond, please see Form I-945, Public Charge Bond, and its instructions. Information addressing substitution of public charge bonds may be found in 8 CFR 213.1.	[delete]
Pages 1-2, When Will USCIS Cancel a Public Charge Bond?	[Page 1] When Will USCIS Cancel a Public Charge Bond? A public charge bond will be cancelled once the alien has naturalized, permanently departed the United States, or died. See INA section 213 and 8 CFR 213.1. The bond may also be cancelled upon the fifth anniversary of the alien’s adjustment of status to that of a lawful permanent resident, or if the alien, following the grant of lawful permanent resident status, obtains another immigration status in the United States that is exempt from the public charge ground of inadmissibility. See INA section 212(a)(4). [Page 2] Regardless of the reason an obligor or the alien may seek to cancel the public charge bond, the U.S. Department of Homeland Security (DHS) will only cancel the public charge bond if: 1. The obligor (or agent/co-obligor) or the alien file this form to request cancellation of the public charge bond; and 2. The alien can establish that he or she has not received 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, and has otherwise complied with the conditions of the bond. When examining whether the bond can be cancelled, USCIS evaluates whether the conditions of the bond are satisfied and all requirements for cancellation are met. If this application and the evidence does not establish that the bond can be cancelled, the bond will remain in place until the conditions for cancellation of the bond are met. USCIS will inform the obligor and the alien of the decision. The obligor, but not the alien (or the alien’s representative, if applicable), may appeal the decision in accordance with 8 CFR 103, Subpart A.	[Page 1] When Will USCIS Cancel a Public Charge Bond? A public charge bond will be cancelled once the alien dies, has permanently departed from the United States, is naturalized, or after the fifth anniversary of the alien becoming a lawful permanent resident (LPR). See Immigration and Nationality Act (INA) section 213 and 8 CFR 103.6(c)(1). Regardless of the reason cancellation of the public charge bond is requested, USCIS will only cancel the public charge bond if: 1. The obligor (or agent/co-obligor) or the alien (or the alien’s attorney or accredited representative, if any, or if the alien is deceased, the executor of the alien’s estate) files this form to request cancellation of the public charge bond; and 2. The public charge bond was not breached. A bond is breached when there has been a substantial violation of the stipulated conditions, such as the receipt of any means-tested public benefit. When examining whether the public charge bond can be cancelled, USCIS evaluates whether there has been a breach of the bond and all requirements for cancellation are met. If this request and the evidence does not establish that the bond can be cancelled, the bond will remain in effect until the conditions for cancellation of the bond are met. USCIS will inform the obligor and the alien of the decision. The obligor, but not the alien (or the alien’s representative, if applicable), may appeal the decision in accordance with 8 CFR 103, Subpart A.
Pages 2-3, General Instructions	[Page 2] General Instructions USCIS provides forms free of charge through the USCIS website. In order to view, print, or fill out our forms, you should use the latest version of Adobe Reader, which you can download for free at http://get.adobe.com/reader/. If you do not have Internet access, you may call the USCIS Contact Center at 1-800-375-5283 and ask that we mail a form to you. For TTY (deaf or hard of hearing) call: 1-800-767-1833. Signature. Each part of the form must be properly signed. For all signatures on this form, USCIS will not accept a stamped or typewritten name in place of a signature. If you are under 14 years of age, your parent or legal guardian may sign the form on your behalf. A legal guardian may also sign for a mentally incompetent person. If the alien is deceased, the alien’s executor may sign for the alien. An agent/co-obligor acting as the authorized agent may sign on behalf of the obligor. Validity of Signatures. USCIS will consider a photocopied, faxed, or scanned copy of the original, handwritten signature valid for filing purposes. The photocopy, fax, or scan must be of the original document containing the handwritten, ink signature. Executors signing on behalf of a deceased alien must submit a certified copy of the document that establishes the legal authority to act on behalf of the alien’s estate, such as a small estate affidavit, a will, or a court order. Evidence. At the time of filing, you must submit all evidence and supporting documentation listed in the Instructions. Copies. You should submit legible photocopies of the documents requested, unless the Instructions specifically state that you must submit an original document. USCIS may request an original document at the time of filing or at any time during processing of an application, petition, or request. If USCIS requests an original document from you, it will be returned to you after USCIS determines it no longer needs your original. NOTE: If you submit original documents when not required or requested by USCIS or the Immigration Court, your original documents may be immediately destroyed after we receive them. Translations. If you submit a document with information in a foreign language, you must also submit a full English translation. The translator must sign a certification that the English language translation is complete and accurate, and that he or she is competent to translate from the foreign language into English. The certification must include the translator’s signature. DHS recommends the certification contain the translator’s printed name, the signature date, and the translator’s contact information. [Page 3] How to Fill Out Form I-356 1. Type or print legibly in black ink. 2. If you need extra space to complete any item within this form, use the space provided in Part 9. Additional Information or attach a separate sheet of paper. Type or print the alien’s name and Alien Registration Number (A-Number) (if any), and the obligor’s name and bond receipt number at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet. 3. Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been married and the question asks, “Provide the name of your current spouse”), type or print “N/A” unless otherwise directed. If your answer to a question which requires a numeric response is zero or none (for example, “How many children do you have” or “How many times have you departed the United States”), type or print “None” unless otherwise directed.	[Page 2] General Instructions We provide free forms through the USCIS website. To view, print, or complete our forms, you should use the latest version of Adobe Reader, which you can download for free at http://get.adobe.com/reader/. If you do not have Internet access, you may call the USCIS Contact Center and ask that we mail a form to you. Signature. You (or your signing authority) must properly complete your request. USCIS will not accept a stamped or typewritten name in place of any signature on this request. If you are under 14 years of age, your parent or legal guardian may sign the request on your behalf. A legal guardian may also sign for a mentally incompetent person. If your request is not signed, or if the signature is not valid, we will reject your request. See 8 CFR 103.2(a)(7)(ii)(A). If USCIS accepts a request for adjudication and determines that it has a deficient signature, USCIS will deny the request. Validity of Signatures. USCIS will consider a photocopied, faxed, or scanned copy of an original, handwritten signature as valid for filing purposes. The photocopy, fax, or scan must be of the original document containing the handwritten, ink signature. Executors signing on behalf of a deceased alien must submit a certified copy of the document that establishes the legal authority to act on behalf of the alien’s estate, such as a small estate affidavit, a will, or a court order. Evidence. When you file your request, you must submit all evidence and supporting documentation listed in the Instructions. Biometric Services Appointment. USCIS may require you to 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. If we determine that a biometric services appointment is necessary, we will send you an appointment notice with the date, time, and location of your appointment. If you are currently overseas, your notice will instruct you to contact a U.S. Embassy, U.S. Consulate, or USCIS office outside the United States to schedule an appointment. At your biometrics appointment, you must sign an oath reaffirming that: 1. You provided or authorized all information in the request; 2. You reviewed and understood all of the information contained in, and submitted with, your request; and 3. All of this information was complete, true, and correct at the time of filing. If you do not attend your biometric services appointment, we may deny your request. Copies. You should submit legible photocopies of requested documents unless the Instructions specifically instruct you to submit an original document.  USCIS may request an original document at any time during our process. If we request an original document from you, we will return it to you after USCIS determines it no longer needs the original. NOTE: If you submit original documents when they are not required or requested, USCIS may destroy them after we receive them. Translations. If you submit a document with information in a foreign language, you must also submit a full English translation. The translator must sign a certification that the English language translation is complete and accurate, and that he or she is competent to translate from the foreign language into English. The certification must also include the translator’s signature, printed name, the signature date, and the translator’s contact information. USCIS Contact Center. For additional information on the form and instructions about where to file, change of address, and other questions, visit the USCIS Contact Center at www.uscis.gov/contactcenter or call at 800-375-5283 (TTY 800-767-1833). The USCIS Contact Center provides information in English and Spanish. [Page 3] How to Complete Form I-356 1. Type or print legibly in black ink. 2. If you need extra space to complete any item within this form, use the space provided in Part 8. Additional Information or attach a separate sheet of paper. Type or print the alien’s name and Alien Registration Number (A-Number) (if any), and the obligor’s name and bond receipt number at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet. 3. Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been married and the question asks, “Provide the name of your current spouse”), type or print “N/A” unless otherwise directed. If your answer to a question which requires a numeric response is zero or none (for example, “How many children do you have” or “How many times have you departed the United States”), type or print “None” unless otherwise directed.
Pages 3-9, Specific Instructions	[Page 3] Specific Instructions Part 1. Obligor and Agent/Co-Obligor Information (To Be Completed by the Obligor or Agent/Co-Obligor) Provide the obligor’s, agent/co-obligor’s, and bond information as requested in the form. For surety bonds, please include the name of the surety company. Part 2. Obligor’s or Agent/Co-Obligor’s Statement, Contact Information, Certification, and Signature (To Be Completed by the Obligor or Agent/Co-Obligor) Choose the appropriate statement and complete the needed entries. Then sign and date the certification in the appropriate spaces. Part 3. Information about the Alien for Whom the Public Charge Bond Was Issued (To Be Completed By the Alien or the Alien’s Executor) Provide the information requested in this Part. Item Number 1. Alien Registration Number (A-Number) (if any). An Alien Registration Number, otherwise known as an “A-Number,” is typically issued to people who apply for, or are granted, certain immigration benefits. Your A-Number appears on the front of Form I-551, your Permanent Resident Card. If you have more than one A-Number, use the space provided in Part 9. Additional Information to provide the information. If you do not have the A-Number, leave this space blank. Item Number 2. U.S. Social Security Number (SSN) (if any). Provide the U.S. Social Security Number, if you have one. Item Number 3. USCIS Online Account Number (if any). If you have previously filed an application or petition using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)), provide the USCIS Online Account Number you were issued by the system. You can find your USCIS Online Account Number by logging in to your account and going to the profile page. If you previously filed certain applications or petitions on a paper form through a USCIS Lockbox facility, you may have received a USCIS Online Account Access Notice issuing you a USCIS Online Account Number. You may find your USCIS Online Account Number at the top of the notice. If you were issued a USCIS Online Account Number, enter it in the space provided. The USCIS Online Account Number is not the same as an A-Number. Item Number 4. Current Legal Name. Provide your legal name, as shown on your birth certificate or legal name change document. If you have two last names, include both and use a hyphen (-) between the names, if appropriate. Type or print your last, first, and middle names in each appropriate field. [Page 4] Item Number 5. Other Names You Have Used Since Birth. Provide all the names you have used since birth, including maiden name, any nicknames, and any names that appear in your documents. If you need extra space, use Part 9. Additional Information to provide other names used. Item Number 6. Gender. Select the box that indicates whether you are male or female. Item Number 7. Date of Birth. Enter your date of birth in mm/dd/yyyy format in the space provided. For example, type or print October 5, 1967 as 10/05/1967. Item Number 8. Place of Birth. Enter the name of the city or town, and country where you were born. Type or print the name of the country as it was named when you were born, even if the country’s name has changed or the country no longer exists. Item Number 9. Country of Citizenship or Nationality. Enter the name of the country where you are a citizen. This is not necessarily the country where you were born. If you are stateless, type or print the name of the country where you were last a citizen or national. If you are a citizen or national of more than one country, type or print the name of the country that issued your last passport. Item Number 10. Mailing Address. Provide a valid mailing address. Item Number 11. Physical Address. If the place where you live is different from your mailing address, type or print the address where you currently live. Item Number 12. Past Residences. List all your past residences since you became a lawful permanent resident. Start with the most recent residence. Part 4. Reason for Cancellation of the Bond Answer the questions below and provide the information requested. You should indicate whether any of the circumstances addressed in the questions have occurred since you adjusted your status to that of a lawful permanent resident (for which a bond was submitted on your behalf).) Item Number 1. U.S. Citizenship. Indicate whether or not you have become a U.S. citizen. If yes, please provide proof of your citizenship. Item Number 2. Permanent Departure. Indicate that you permanently departed the United States. For the specific purpose of cancelling a bond, evidence of such permanent departure includes: 1. Evidence that you have submitted Form I-407, Record of Abandonment of Lawful Permanent Resident Status, from outside the United States and have actually departed the United States; 2. Evidence that you were placed into removal (or exclusion or deportation proceedings), and were physically removed, excluded, or deported from the United States; or 3. Evidence that an immigration judge granted you voluntary departure under INA 240B, and that you departed while the voluntary departure order was in effect. Provide all information that is requested in Item Number 2. and attach the evidence that is requested in each Item Number. USCIS will not cancel a bond in certain situations, even if you may have abandoned or lost your lawful permanent resident status. These situations include the following: 1. You left the United States to live abroad permanently and with the intention to abandon your LPR status but did not submit Form I-407 from outside the United States and according to its instructions; [Page 5] 2. Your lawful permanent resident status was rescinded or revoked, whether in removal proceedings or not, but you are unable to show that you have left the United States; or 3. You have an outstanding voluntary departure order or outstanding removal (or exclusion or deportation) order but you have not yet departed the United States or have not yet been removed, excluded, or deported. Item Number 3. Death of the Alien. If the alien for whom the bond was posted has died since the bond was accepted by DHS, and you are the executor of the alien’s affairs or otherwise acting on behalf of the alien’s estate, please answer the questions and provide the information requested in Items A. through B. and Item Number 4., including your relationship to the deceased. Please attach a certified copy of the document that establishes your legal authority to act on behalf of the alien’s estate, such as a, small estate affidavit, will, or a court order, or your relationship to the deceased. Please also provide a certified copy of the death certificate. Item Number 4. Five Years as a Lawful Permanent Resident. Answer “Yes” if you have been a lawful permanent resident for at least five years. Provide the date when you became a lawful permanent resident, in mm/dd/yyyy format. Provide a copy of your lawful permanent resident card. Part 5. Alien’s Receipt of Public Benefits Since Alien’s Adjustment of Status to that of a Lawful Permanent Resident (To be Completed by the Alien or the Alien’s Executor (if the Alien is Deceased)) Please provide the information requested about your (the alien’s) receipt of public benefits, as defined in 8 CFR 212.21(b) (listed below) 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), since your adjustment of status to that of a lawful permanent resident (for which a bond was submitted on your behalf). If you have terminated the receipt of benefits, provide the documentation that indicates you will no longer receive the benefits with the applicable termination date. Receipt means when a benefit-granting agency provides or has provided a public benefit to you whether in the form of cash, voucher, services, or insurance coverage. NOTE: DHS will only consider the public benefits received by or attributable to the alien himself or herself. In addition, USCIS does not consider any public benefits received after a person becomes a U.S. citizen. You do not need to provide information of public benefits received after you became a citizen, if applicable. In the space designated, please provide all requested information about each public benefit regardless of the amount or the duration. USCIS will calculate the relevant public benefit receipt duration to determine whether the alien breached the bond. If the alien breached the bond, USCIS will not cancel the bond. (Please note that you need to respond even if you fall within one of categories of individuals for whom receipt of public benefits will not be considered – see the table below for evidence that must be provided to document that the alien qualifies for the exemption). Please select all that apply. If you require additional space, please use the space provided in Part 9. Additional Information. In the space provided, indicate you have received, since your adjustment of status to that of a lawful permanent resident (for which a bond was submitted on your behalf) any of the following benefits (select all that apply): 1. Any Federal, state, local, or tribal cash assistance for income maintenance; 2. Supplemental Security Income (SSI); 3. Temporary Assistance for Needy Families (TANF); 4. Federal, State or local cash benefit programs for income maintenance (often called “General Assistance” in the State context, but which may exist under other names); 5. Supplemental Nutrition Assistance Program (SNAP, or formerly called “Food Stamps”); 6. Section 8 Housing Assistance under the Housing Choice Voucher Program; 7. Section 8 Project-Based Rental Assistance (including Moderate Rehabilitation); 8. Public Housing under the Housing Act of 1937, 42 U.S.C. 1437 et seq.; or 9. Federally-Funded Medicaid. [Page 6] If you have not received any of the public benefits listed above, please select that option. If you are not currently certified to receive any of the public benefits listed above, please select that option As part of the determination of whether USCIS can cancel the bond or whether the alien has breached the bond, USCIS will consider the above listed public benefits except as excluded below. The following is a list of exclusions from the public benefit(s) considerations listed above. If you have received public benefits and belong to one of the following categories, submit the evidence listed below for the applicable categories. [Table, 3 columns (Exclusion/Description/Evidence you must submit to qualify for exclusion (as applicable), 4 rows (U.S. Armed Forces Service Members/Federally-funded Medicaid/Child Acquiring U.S. Citizenship/Public Benefits While in an Immigration Category Exempt from Public Charge] Exclusion U.S. Armed Forces Service Members Description At the time the public benefit was received or at the time you file the request to cancel the bond, or at time of the cancelation determination or the bond breach determination adjudication of this application, you are: An alien enlisted in the U.S. Armed Forces, or serving in active duty or in the Ready Reserve component of the U.S. Armed Forces; The spouse or child of the service member (listed in Item Number 1., above); or The spouse or child of a U.S. citizen or U.S. national serving in the U.S. Armed Forces or in active duty or in the Ready Reserve component of the U.S. Armed Forces. Evidence you must submit to qualify for exclusion (as applicable) Service Members: Certified evidence of alien’s enlistment/service issued by the authorizing official of the executive department in which service member is serving. Spouses and Children of Service Members: Form DD-1173, United States Uniformed Services Identification and Privilege Card (Dependent). [Page 7] Exclusion Federally-funded Medicaid Description Receipt of an alien under 21 years of age; The recipient of Medicaid payment(s) for an “emergency medical condition”; The receipt of Medicaid for services provided under the Individuals with Disabilities Education Act (IDEA); The receipt of Medicaid for school-based non-emergency benefits for children who are of an age eligible for secondary education as determined under state law; or Receipt during pregnancy and during the 60-day period after the last day of the pregnancy. Evidence you must submit to qualify for exclusion (as applicable): A statement with information regarding the “emergency medical condition” determination (if applicable); Documentation of these payments under the IDEA or school-based service; or Pregnancy verification letter from medical professional including estimated duration of pregnancy. Exclusion Children Acquiring US Citizenship Description Child of U.S. citizens whose lawful admission for permanent residence and subsequent residence in the legal and physical custody of their U.S. citizen parent will result in the child’s automatically acquiring U.S. citizenship upon meeting the eligibility under INA 320; Child of U.S. citizens whose lawful admission for permanent residence will result automatically in the child’s acquisition of citizenship upon finalization of adoption (if the child satisfies the requirements applicable to adopted children under INA 101(b)(1)), in the United States by the U.S. citizen parent(s), upon meeting the eligibility criteria under INA 320; or Child currently residing abroad who entered the United States with a nonimmigrant visa to attend N-600K, Application for Citizenship and Issuance of Certificate Under INA Section 322 interview. Evidence you must submit to qualify for exclusion (as applicable) Evidence that you are the child of a United States citizen, who will be eligible for acquisition of citizenship under INA 320 and the evidentiary requirements to meet the qualifications to demonstrate citizenship. For more information, see Form N-600, Application for Certificate of Citizenship. A copy of the N-600K interview notice. [Page 8] Exclusion Public Benefits While in an Immigration Category Exempt from Public Charge Description Received public benefits while in a category that is exempt from public charge inadmissibility; or Received public benefits while in a category for which you had received a waiver for public charge inadmissibility. Evidence you must submit to qualify for exclusion (as applicable) Information that evidences your status or that you received a waiver for the public charge ground of inadmissibility, such as: Approval notice (Form I-797, Notice of Action); or Form I-94, Arrival/Departure Record. Documentation: If you have received any of the public benefits listed above, provide evidence in the form of a letter, notice, certification or other agency documents that contain the following: 1. Your name; 2. Name and contact information for the public benefit granting agency; 3. Type of public benefit; 4. Date you started receiving the public benefit or if certified, date you will start receiving the public benefit; and 5. Date benefit or coverage ended or expires (mm/dd/yyyy) (if applicable). If you had applied for a public benefit but withdrew your application, provide proof of the public benefit granting agency receipt of the withdrawal of the application. Part 6. Alien’s (or Alien’s Executor’s) Contact Information, Certification, and Signature Item Numbers 1. - 6. Select the appropriate box to indicate whether you read Form I-356 yourself or whether you had an interpreter assist you. If someone assisted you in completing your parts of Form I-356, select the box indicating that you used a preparer. Further, you must sign and date your certification and provide your daytime telephone number, mobile telephone number (if any), and email address (if any). Every Form I-356 MUST contain the signature of the alien (or parent or legal guardian, or the alien’s executor, if applicable). A stamped or typewritten name in place of a signature is not acceptable. Part 7. Interpreter’s Contact Information, Certification, and Signature Item Numbers 1. - 7. If you (the alien or the alien’s executor) used anyone as an interpreter to read the Instructions and questions on this form to you in a language in which you are fluent, the interpreter must fill out this section; provide his or her name, the name and address of his or her business or organization (if any), his or her daytime telephone number, his or her mobile telephone number (if any), and his or her email address (if any). The interpreter must sign and date this section. [Page 9] Part 8. Contact Information, Certification, and Signature of the Person Preparing the Alien’s Parts of Form I-356, if Other Than the Alien (or the Alien’s Executor) Item Numbers 1. - 8. This section must contain the signature of the person who completed the alien’s parts of Form I-356, if other than, the alien. If the same individual acted as your interpreter and your preparer, that person should complete both Part 7. and Part 8. If the person who completed the alien’s parts of Form I-356 is associated with a business or organization, that person should complete the business or organization name and address information. Anyone who helped you complete Form I-356 MUST sign and date the form. A stamped or typewritten name in place of a signature is not acceptable. If the person who helped you prepare your parts of Form I-356 is an attorney or accredited representative, and you want that person to receive notification on all action taken on this application, he or she must submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, along with this form. Part 9. Additional Information Item Numbers 1. - 7. If you need extra space to provide any additional information within this Form I-356, use the space provided in Part 9. Additional Information. If you need more space than what is provided in Part 9., you may make copies of Part 9. to complete and submit with Form I-356. Type or print the alien’s name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet. We recommend that you print or save a copy of your completed declaration to review in the future and for your records.	[Page 3] Specific Instructions Part 1. Obligor and Agent/Co-Obligor Information (To Be Completed by the Obligor or Agent/Co-Obligor) Provide the obligor’s, agent/co-obligor’s, and bond information as requested in the request. For surety bonds, please include the name of the surety company. Part 2. Obligor’s or Agent/Co-Obligor’s, Contact Information, Certification, and Signature (To Be Completed By the Obligor or Agent/Co-Obligor) Choose the appropriate statement and complete the needed entries. Then sign and date the certification in the appropriate spaces. Part 3. Information About the Alien for Whom the Public Charge Bond Was Issued (To Be Completed By the Alien or the Alien's Executor) [delete] Item Number 1. Alien Registration Number (A-Number) (if any). An Alien Registration Number, otherwise known as an “A-Number,” is typically issued to people who apply for, or are granted, certain immigration benefits. Your A-Number appears on the front of Form I-551, your Permanent Resident Card. If you have more than one A-Number, use the space provided in Part 8. Additional Information to provide the information. If you do not have the A-Number, leave this space blank. Item Number 2. U.S. Social Security Number (SSN) (if any). Provide the U.S. Social Security Number, if you have one. Item Number 3. USCIS Online Account Number (if any). Providing your unique USCIS Online Account Number (OAN) helps you manage your online account.  You have an Online Account Number if you previously filed an application, petition, or request online or by mail and were issued a receipt number that begins with IOE.  If you filed a form online, you can find your OAN in your USCIS Online Account profile.  If you mailed your form, you can find your OAN at the top of the USCIS Account Access Notice we sent you.  The OAN is not the same as an A-Number.  If you do not have a receipt number beginning with IOE, you do not have an OAN. Item Number 4. Current Legal Name. Provide your legal name, as shown on your birth certificate or legal name change document. If you have two last names, include both and use a hyphen (-) between the names, if appropriate. Type or print your last, first, and middle names in each appropriate field. Item Number 5. Other Names You May Have Used Since Birth. Provide all the names you have used since birth, including maiden name, any nicknames, and any names that appear in your documents. If you need extra space, use Part 8. Additional Information to provide other names used. [Page 4] Item Number 6. Sex. Indicate whether you are male or female as provided on your birth certificate issued at the time of birth or issued closest to the time of birth or in secondary evidence you provided to USCIS, if applicable. Item Number 7. Date of Birth. Enter your date of birth in mm/dd/yyyy format in the space provided. For example, type or print October 5, 1967 as 10/05/1967. Item Number 8. Place of Birth. Enter the name of the city or town, and country where you were born. Type or print the name of the country as it was named when you were born, even if the country’s name has changed or the country no longer exists. Item Number 9. Country of Citizenship or Nationality. Provide the name of the country where you are a citizen and/or national. This is not necessarily the country where you were born. If you do not have citizenship in any country, type or print “stateless” and provide an explanation in Part 8. Additional Information. Item Number 10. Mailing Address. Provide a valid mailing address. Item Number 11. Physical Address. If the place where you live is different from your mailing address, type or print the address where you currently live. [delete] Part 4. Reason for Cancellation of the Bond Answer the questions below and provide the information requested. You should indicate whether any of the circumstances addressed in the questions have occurred since you adjusted your status to that of a lawful permanent resident (for which a bond was submitted on your behalf).) Item Number 2. Became a U.S. Citizen. Indicate whether or not you have become a U.S. citizen. If yes, please provide proof of your citizenship. Item Number 3. Permanently Departed the United States. Indicate that you permanently departed the United States. For the specific purpose of cancelling a bond, evidence of such permanent departure may include: 1. Evidence that you have submitted Form I-407, Record of Abandonment of Lawful Permanent Resident Status, from outside the United States and have actually departed the United States; 2. Evidence that you departed or were physically removed from the United States after you received a final order of removal, exclusion, or deportation; or 3. Evidence that an immigration judge granted you voluntary departure under INA section 240B, and that you departed while the voluntary departure order was in effect. Provide all information that is requested in Item Number 3. and attach the evidence that is requested in each Item Number. USCIS will not cancel a bond in certain situations, even if you may have abandoned or lost your lawful permanent resident status. These situations include the following: 1. You left the United States to live abroad permanently and with the intention to abandon your LPR status but did not submit Form I-407 from outside the United States and according to its Instructions; 2. Your lawful permanent resident status was rescinded or revoked, whether in removal proceedings or not, but you are unable to show that you have left the United States; or 3. You have an outstanding voluntary departure order or outstanding removal (or exclusion or deportation) order but you have not yet departed the United States or have not yet been removed, excluded, or deported. [Page 5] Item Number 4. Deceased. If the alien for whom the public charge bond was posted died since the bond was posted, and you are the executor of the alien’s estate, please answer the questions and provide the information requested in Items A. through B. in Item Number 4., including your relationship to the deceased. Please attach a certified copy of the document that establishes your legal authority to act on behalf of the alien’s estate, such as a small estate affidavit, will, or a court order, or your relationship to the deceased. Please also provide a certified copy of the death certificate. Item Number 5. Five Years After Becoming a Lawful Permanent Resident. Answer “Yes” if you have been a lawful permanent resident for at least five years. Provide the date when you became a lawful permanent resident, in mm/dd/yyyy format. Provide a copy of your lawful permanent resident card. Item Number 6. Receipt of Public Benefits. Answer “Yes” if the alien received any means-tested public benefit. Provide a description of the public benefits received and the dates when the benefits were received, as well as the source that provided the benefit (the Federal, or a specific State, territorial, tribal, or local government or government agency). [delete] Part 5. Alien’s (or Alien Executor’s) Contact Information, Certification, and Signature You must sign and date your request and, if applicable, provide your daytime telephone number, mobile telephone number, and email address. The signature of a parent or legal guardian, if applicable, is acceptable. A stamped or typewritten name in place of a signature is not acceptable. Part 6. Interpreter’s Contact Information, Certification, and Signature If you used anyone as an interpreter to read the Instructions and questions on this request to you in a language in which you are fluent, the interpreter must fill out this section and sign and date the request. Part 7. Contact Information, Declaration, and Signature of the Person Preparing Parts of Form I-356, if Other Than the Alien (or the Alien’s Executor) The person who completed your request, if other than the alien or the alien's executor, must sign this section. If the same individual acted as your interpreter and your preparer, then that person should complete both Part 6. and Part 7. A stamped or typewritten name in place of a signature is not acceptable. Part 8. Additional Information If you need extra space to provide any additional information within this Form I-356, use the space provided in Part 8. Additional Information. If you need more space than what is provided in Part 8., you may make copies of Part 8. to complete and submit with Form I-356. Type or print the alien’s name and A-Number (if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet. We recommend that you print or save a copy of your completed request for your records.
Page 9, What Is the Filing Fee?	[Page 9] What Is the Filing Fee? The filing fee Form I-356 is $25.	[Page 5] What Is the Filing Fee? See USCIS Form G-1055, Fee Schedule, available at www.uscis.gov/g-1055, for all information on filing fees.
Page 9, Where to File?	[Page 9] Where To File? Please see our website at www.uscis.gov/I-356 or call our USCIS Contact Center at 1-800-375-5283 for the most current information about where to file this form. For TTY (deaf or hard of hearing) call: 1-800-767-1833.	[Page 6] Where To File? Please see our website at www.uscis.gov/I-356 for the most current information about where to file this request.
Page 10, USCIS Forms and Information	[Page 10] USCIS Forms and Information To ensure you are using the latest version of this form, please visit the USCIS website at www.uscis.gov where you can obtain the latest USCIS forms and immigration-related information. If you do not have internet access, you may order USCIS forms by calling the USCIS Contact Center at 1-800-375-5283. For TTY (deaf or hard of hearing) call: 1-800-767-1833. Instead of waiting in line for assistance at your local USCIS office, you can schedule an appointment online at www.uscis.gov. Select “Make an Appointment” and follow the screen prompts to set up your appointment. Once you finish scheduling an appointment, the system will generate an appointment notice for you.	[Page 6] USCIS Forms and Information To ensure you are using the latest version of this request, visit www.uscis.gov.
Page 10, Penalties	[Page 10] Penalties If you, the obligor, co-obligor or the alien, knowingly and willfully falsify or conceal a material fact or submit a false document with your Form I-356, we may deny the request to cancel the bond. In addition, you will face severe penalties provided by law and may be subject to criminal prosecution.	[Page 6] Penalties If you, the obligor, co-obligor, or the alien, knowingly and willfully falsify or conceal a material fact or submit a false document with your Form I-356, USCIS may deny the request to cancel the bond. In addition, you will face severe penalties provided by law and may be subject to criminal prosecution.
Page 10, USCIS Compliance Review and Monitoring	[Page 10] USCIS Compliance Review and Monitoring By signing this form, you, the obligor, co-obligor and alien, have stated under penalty of perjury (28 USC section 1746) that all information and documentation submitted with this form are complete, true, and correct. You also authorize the release of any information from your records that USCIS may need to determine your eligibility for the immigration benefit you are seeking and consent to USCIS verifying such information. The Department of Homeland Security (DHS) has the authority to verify any information you submit to establish that the bond should be cancelled. USCIS’ legal authority to verify this information is in Title 8 USC sections 1103, 1182, and 1183, and 8 CFR Parts 103 and 213, as well as Title 26 USC 6109, Title 31 U.S.C. 7701 and Executive Order 9397. To ensure compliance with applicable laws and authorities, USCIS may verify information before or after your case is decided. Agency verification methods may include, but are not limited to: review of public records and information; contact through written correspondence, the Internet, facsimile, other electronic transmission, or telephone; unannounced physical site inspections of residences and locations of employment; and interviews. USCIS will use information obtained through verification to assess your compliance with the laws and to determine whether the bond should be cancelled. Subject to the restrictions under 8 CFR 103.2(b)(16), USCIS will provide you with an opportunity to address any adverse or derogatory information. USCIS may also provide an opportunity to address any adverse 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 which may result in revocation of the cancellation of the public charge bond.	[Page 6] USCIS Compliance Review and Monitoring By signing this request, you, the obligor, co-obligor, and alien, have stated under penalty of perjury (28 USC section 1746) that all information and documentation submitted with this form are complete, true, and correct. You also authorize the release of any information from your records that USCIS may need to determine your eligibility for the immigration benefit you are seeking and consent to USCIS verifying such information. The Department of Homeland Security (DHS) has the authority to verify any information you submit to establish that the bond should be cancelled. Our legal authority to verify this information is in Title 8 U.S.C. sections 1103, 1182, and 1183, and 8 CFR Parts 103 and 213, as well as Title 26 USC 6109, Title 31 U.S.C. 7701 and Executive Order 9397. To ensure compliance with applicable laws and authorities, we may verify information before or after your case is decided. Agency verification methods may include, but are not limited to: reviewing public records and information; contacting through written correspondence; using the internet, fax, other electronic transmission, or telephone; making unannounced physical site inspections of residences and locations of employment; and interviewing people. USCIS will use the information we obtain to assess your compliance with the laws and to determine your eligibility for an immigration benefit. [Page 7] Subject to the restrictions under 8 CFR 103.2(b)(16), USCIS will provide you with an opportunity to address any adverse or derogatory information that may result from a compliance review, verification, or site visit before a decision is made on your request. For a visit after your request is approved, USCIS will provide you with an opportunity to address any adverse or derogatory information which may result in revocation or termination of an approval.
Page 11, DHS Privacy Notice	[Page 11] DHS Privacy Notice AUTHORITIES: The information requested on this form, and the associated evidence, is collected under the Immigration and Nationality Act sections 103 and 212(a)(4) and 213, as well as Title 26 USC 6109, Title 31 USC 7701 and Executive Order 9397. PURPOSE: The primary purpose for providing the requested information on this form is to determine whether the public charge bond should be cancelled. USCIS uses the information you provide to grant or deny the request for cancellation of the public charge bond. DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, including your TIN and Social Security number (if applicable), and any requested evidence, may delay a final decision or result in denial of your request. ROUTINE USES: DHS may share the information you provide on this form 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-001 - Alien File, Index, and National File Tracking System and DHS-USCIS-007 - Benefits Information System] and the published privacy impact assessments [DHS/USCIS/PIA-016a Computer Linked Application Information Management System and Associated Systems,] which you can find at www.dhs.gov/privacy. DHS may also share this information, as appropriate, for law enforcement purposes or in the interest of national security.	[Page 7] DHS Privacy Notice AUTHORITIES: USCIS is collecting the information requested on this form, and the associated evidence, under the Immigration and Nationality Act sections 103, 212(a)(4), and 213, as well as Title 26 USC 6109, Title 31 USC 7701 and Executive Order 9397. PURPOSE: The primary purpose for providing the requested information on this form is to determine whether the public charge bond should be cancelled. USCIS uses the information you provide to grant or deny the request for cancellation of the public charge bond. DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, including your TIN and Social Security number (if applicable), and any requested evidence, may delay a final decision or result in USCIS denying your request. ROUTINE USES: DHS may, where allowable under relevant confidentiality provisions, share the information you provide on this form 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-001 - Alien File, Index, and National File Tracking System and DHS-USCIS-007 - Benefits Information System] and the published privacy impact assessments [DHS/USCIS/PIA-016a Computer Linked Application Information Management System and Associated Systems,] which you can find at www.dhs.gov/privacy. DHS may also share this information, as appropriate, for law enforcement purposes or in the interest of national security.
Page 11, Paperwork Reduction Act	[Page 11] Paperwork Reduction Act An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection of information, unless it displays a currently valid Office of Management and Budget (OMB) control number. The public reporting burden for this collection of information is estimated at 45 minutes per response, including the time for reviewing instructions, gathering the required documentation and information, completing the form, preparing statements, attaching necessary documentation, and submitting the form. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Office of Policy and Strategy, Regulatory Coordination Division, 5900 Capital Gateway Drive, Mail Stop #2140, Camp Springs, MD 20588-0009; OMB No. 1615-0005. Do not mail your completed Form I-356 to this address.	[Page 11] Paperwork Reduction Act USCIS may not conduct or sponsor an information collection, and you are 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 0.75 hours per response, including the time for reviewing instructions, gathering the required documentation and information, completing the application, preparing statements, and attaching necessary documentation. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Office of Policy and Strategy, Regulatory Coordination Division, 5900 Capitol Gateway Drive, Mail Stop #2140, Camp Springs, MD 20588-0009; OMB No. 1615-0136. Do not mail your completed Form I-945 to this address.

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