Affidavit of Financial Support

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OMB 0970-0278 [valid through MM/DD/YYYY]

Administration for Children & Families
Office of Refugee Resettlement

Affidavit of Financial Support
About this Form
This form may be used to meet the proof of income requirement in the Sponsor Application, which requires
potential sponsors to provide documentation demonstrating that there are sufficient financial resources to
provide for a released child's physical and mental well-being as required under 8 U.S.C. 1232(c)(3)(A) and 45
C.F.R. 410.1202(c). Potential sponsors can submit multiple affidavits of support. A sponsor may submit an
affidavit of support for their own income, as well as multiple affidavits of support for any financial supporters.

Important Warnings
It is important to complete all sections accurately and truthfully. Sponsors and/or sponsor's financial
supporters must declare and affirm under penalty of perjury that the information contained in this form, is true
and accurate to the best of their knowledge and that it is free of error and fraud. Any fraud will be referred to
Federal law enforcement and may lead to denial of the sponsor's application.
Incomplete or inaccurate information may delay processing. Failure to meet the proof of income requirement
may result in a denial or delay in processing of your Sponsor Application.
In certain instances, a Federal Field Specialist or interpreter may assist you in completing this form to expedite
the Sponsor Application. For an individual with limited English proficiency, ORR recommends the use of a
qualified interpreter1 and/or qualified translator2 to help you complete this form, if needed. Using an
unqualified interpreter may put you at risk of fraud or misuse of your sensitive information.

1

For a limited English proficient individual, an interpreter who, via a remote interpreting service or an on-site appearance: Has
demonstrated proficiency in speaking and understanding both spoken English and at least one other spoken language; and Is able
to interpret effectively, accurately, and impartially to and from such language(s) and English, using any necessary specialized
vocabulary or terms without changes, omissions, or additions, and while preserving the tone, sentiment, and emotional level of the
original oral statement. Adheres to generally accepted interpreter ethics principles, including client confidentiality.

2

A translator who: Has demonstrated proficiency in writing and understanding both written English and at least one other written
non-English language; Is able to translate effectively, accurately, and impartially to and from such language(s) and English, using any
necessary specialized vocabulary or terms without changes, omissions, or additions, and while preserving the tone, sentiment, and
emotional level of the original written statement; and Adheres to generally accepted translator ethics principles, including client
confidentiality.

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) Public reporting burden for this collection of information is estimated to average 1.0 hour per response,
including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct
or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Please see the
accompanying privacy notice / Privacy Act statement for a discussion of (1) the authority for solicitation of information, and whether disclosure is mandatory or
voluntary, (2) the principal purposes for which the information is intended to be used, (3) other routine uses which may be made of the information, and (4) the
effects, if any, of not providing all or any part of the requested information. If you have any comments on this collection of information please contact
[email protected].

Sponsor Application Packet | Version 19
SAP-8 (ENG) Affidavit of Financial Support
Revised MM/DD/YYYY

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Affidavit of Financial Support
Office of Refugee Resettlement

Section 1: Your Financial Information

In this section you will provide the names of the individuals involved in the sponsorship process and details
about your financial status and ability to support the child and/or sponsor.
1) Your Role
Select the appropriate option.

Sponsor

Sponsor’s Financial Supporter

2) Your Name
Enter your full legal name.
3) Sponsor's Name
Enter the name of the person applying to be
the child's sponsor or enter “self” if you are the
sponsor.
4) Child(ren)'s Name(s)
Enter the name(s) of the unaccompanied alien child(ren) listed in the Sponsor Application. Check in with the
sponsor or Federal Field Specialist for the child(ren)'s full legal name(s) if you are unsure.

5) The number of dependents
Enter the number of individuals who rely on your income to provide for the majority
of their basic needs (e.g., housing, food, healthcare). This could include children, a nonworking spouse or partner, elderly parents or other relatives who can’t support
themselves.

EMPLOYMENT
6) Employment Status
Enter one of the following: Employed, Selfemployed, Unemployed (seeking work), Retired,
Not in the labor force (not seeking work)
7) Employer and Occupation
If you are employed, enter the name of your employer(s) and your occupation. If you are self-employed,
enter “self” for employer name.
Employer Name

Occupation

Annual Income

Need Help? Contact your Federal Field Specialist.
Sponsor Application Packet | Version 19
SAP-8 (ENG) Affidavit of Financial Support
Revised MM/DD/YYYY

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Affidavit of Financial Support
Office of Refugee Resettlement

INCOME

Complete the applicable subsections.

Employment Income
8) Total estimated annual employment income
Enter the total annual income received from the employers/occupations you listed
above in U.S. dollars. Enter the amount received before any deductions such as taxes
or insurance.

Other Income
9) Identify other sources of income that you have.
This could include unemployment benefits, strike pay, gifts, annuities, alimony, proceeds from a settlement,
Temporary Assistance for Needy Families (TANF), Supplemental Security Income (SSI), cash assistance, etc.

10) Total estimated annual income from other sources
Enter the total annual income received from sources other than employment in U.S.
dollars. Enter the amount received before any deductions such as taxes or
insurance.

Total Estimated Annual Income
11) Total estimated annual income
Enter your total estimated annual income in U.S. dollars (add your total estimated
employment income and income from other sources). This may be compared to the
HHS Poverty Guidelines to assess financial support available to the sponsor.

ASSETS

Complete if applicable.
12) Identify the type of asset(s) that you have
This could include savings, investments, real estate, vehicles, valuable personal property, etc.

Need Help? Contact your Federal Field Specialist.
Sponsor Application Packet | Version 19
SAP-8 (ENG) Affidavit of Financial Support
Revised MM/DD/YYYY

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Affidavit of Financial Support
Office of Refugee Resettlement

13) Identify the total value of your assets
Enter the total estimated value of assets you listed above.

FINANCIAL SUPPORT COMMITMENT
Only complete if you are not the sponsor.

14) Total amount that you will provide to the sponsor each month
Specify the monthly financial assistance you will provide to the sponsor.

COMMENTS
15) Related comments
Use this section to provide any additional information about your financial support, employment, or
income sources.

Need Help? Contact your Federal Field Specialist.
Sponsor Application Packet | Version 19
SAP-8 (ENG) Affidavit of Financial Support
Revised MM/DD/YYYY

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Affidavit of Financial Support
Office of Refugee Resettlement

Section 2: Signatures

This section confirms that the information provided is accurate. By signing this form, you acknowledge that
providing false information may result in administrative, civil, or criminal penalties.
I declare and affirm under penalty of perjury that the information contained in this application is true and
accurate to the best of my knowledge.
I understand that knowingly and willfully falsifying, concealing, or covering up a material fact, or making any
materially false, fictitious, or fraudulent statement or representation, or making or using any false writing or
document knowing it contains any materially false, fictitious, or fraudulent statement or entry, is a violation of
18 U.S.C. § 1001 and may subject me to fines, imprisonment, or both.
I authorize release of information in this affidavit in order to support the child and/or the applying sponsor.

Your Signature

Your Name

Date

STAFF USE ONLY - The Federal Field Specialist must complete this section if they assisted the sponsor
applicant with entering information into this form.
I attest under penalty of perjury that to the best of my knowledge:
• Any information I entered into this form on behalf of the sponsor applicant is an accurate and
complete representation of information provided to me by the sponsor applicant; and
• I have not altered or otherwise misrepresented the information provided by the sponsor applicant.

Federal Field Specialist Signature

Federal Field Specialist Name

Date

Need Help? Contact your Federal Field Specialist.
Sponsor Application Packet | Version 19
SAP-8 (ENG) Affidavit of Financial Support
Revised MM/DD/YYYY

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