Sponsor Information
Sponsor Full Name: [[Sponsor Full Name]]
Sponsor Address: [[Sponsor Address]]
Sponsor Date of Birth: ________________________________________________
Sponsor Place of Birth: ________________________________________________
Sponsor U.S. Social Security Number (last 4 digits or full as required): ________________________________________________
Sponsor Citizenship or Immigration Status: ________________________________________________
Sponsor Relationship to Beneficiary: [[Beneficiary Relationship to Sponsor]]
The Sponsor is a U.S. citizen, lawful permanent resident, or other qualifying individual as defined under INA §213A and 8 C.F.R. §213a.
Beneficiary Information
Beneficiary Full Name: [[Beneficiary Full Name]]
Beneficiary Date of Birth: ________________________________________________
Beneficiary Place of Birth (country): ________________________________________________
Beneficiary Relationship to Sponsor: [[Beneficiary Relationship to Sponsor]]
Visa Category or Petition Basis: [[Visa Category]]
USCIS Form Type: [[USCIS Form Type]]
The Beneficiary is the individual for whom the Sponsor is providing this affidavit of support in connection with an application for an immigrant or nonimmigrant visa, adjustment of status, or other immigration benefit.
Household Size and Income Requirements (I-864 Context)
For I-864 Affidavits of Support, the Sponsor's income must meet or exceed 125% of the Federal Poverty Guidelines for the applicable household size (or 100% for active-duty U.S. military sponsors of spouse or child).
Sponsor Annual Income (most recent tax year): [[Sponsor Annual Income]]
Household Size (as defined by USCIS for I-864 purposes): [[Household Size]]
Year of HHS Poverty Guidelines Used: 2026 (or most recent I-864P table year)
The Sponsor certifies that the income stated above is from lawful sources and is expected to continue. Household size includes the Sponsor, the Sponsor's spouse, any children under 21, any other dependents claimed on the most recent tax return, the Beneficiary, and any other individuals the Sponsor is legally obligated to support under prior I-864 affidavits.
Supporting Evidence of Income and Assets
The Sponsor attaches or will provide the following evidence (as required or requested by USCIS):
- Most recent federal income tax return (Form 1040) with all schedules and W-2s or 1099s.
- Proof of current employment and income (pay stubs, employer letter, or business financial statements if self-employed).
- Proof of assets (bank statements, brokerage statements, real property evidence) if income alone is insufficient.
- Proof of U.S. citizenship or lawful permanent resident status (copy of passport, birth certificate, naturalization certificate, or green card).
- If using a joint sponsor: the joint sponsor's complete I-864 and supporting evidence.
If the Sponsor's income falls short of the 125% (or 100%) threshold, a joint sponsor may be used. The joint sponsor must meet the income requirement independently on the basis of their own household size and must execute a separate Affidavit of Support.
Legal Obligation and Duration of Support (I-864)
By executing this Affidavit of Support under INA §213A, the Sponsor agrees to the following:
- The Sponsor will provide support to the Beneficiary at a level that ensures the Beneficiary's income is at least 125% of the Federal Poverty Guidelines (or 100% for qualifying military sponsors) until the obligation ends.
- The support obligation is a legally enforceable contract between the Sponsor and the U.S. Government, as well as between the Sponsor and the Beneficiary.
- The obligation continues until the earliest of: (a) the Beneficiary becomes a U.S. citizen; (b) the Beneficiary has worked or can be credited with 40 qualifying quarters of coverage under the Social Security Act; (c) the Beneficiary departs the United States and abandons permanent residence; (d) the Beneficiary dies; or (e) in certain divorce cases for spouses, the termination conditions under INA §213A are met.
- The Sponsor may be sued in court by the Beneficiary, the U.S. Government, or any state agency that provides means-tested public benefits to the Beneficiary to recover the cost of benefits provided.
- The Sponsor must notify USCIS of any change of address within 30 days using Form I-865.
The Sponsor acknowledges that this obligation is in addition to, and not in place of, any obligations under family law or other agreements.
I-134 (Nonimmigrant / Humanitarian) Context
When this Affidavit is submitted as Form I-134, the Sponsor agrees to support the Beneficiary during the temporary stay in the United States and to ensure the Beneficiary will not become a public charge. The income and household size representations are made under penalty of perjury, and the Sponsor accepts responsibility for the Beneficiary's support and any public charges incurred.
The duration of the I-134 obligation is generally the period of the Beneficiary's authorized stay or until the Beneficiary departs or obtains another status.
Joint Sponsor Option
If a joint sponsor is required:
Joint Sponsor Full Name: ________________________________________________
Joint Sponsor Annual Income: ________________________________________________
Joint Sponsor Household Size: ________________________________________________
The joint sponsor must complete a separate Affidavit of Support and provide full supporting documentation. The primary Sponsor remains liable even if a joint sponsor is used.
Attorney or Accredited Representative Review
The Sponsor and Beneficiary are strongly encouraged to have this Affidavit and all supporting documentation reviewed by an attorney licensed to practice immigration law or by an accredited representative recognized by the Board of Immigration Appeals before submission to USCIS. Immigration law and the interpretation of income, household size, and support obligations are complex and subject to change. Use of this template does not create an attorney-client relationship.
Reference is made to the current I-864P, Poverty Guidelines, and the Instructions for Form I-864 and Form I-134 published by USCIS.
Sponsor's Oath and Certification
I, [[Sponsor Full Name]], certify under penalty of perjury under the laws of the United States of America that:
- I am the Sponsor named above and all information I have provided is true and correct.
- I have read and understand the legal obligations described in this Affidavit and the applicable USCIS forms and instructions.
- My income and/or assets are sufficient to meet the support requirements for the household size stated.
- I will fulfill my support obligations as required by law.
Sponsor Signature: ______________________________________________
Printed Name: [[Sponsor Full Name]]
Date: ______________________________________________
Notary or Declaration (If Required)
(For I-864, notarization is generally not required; the form uses a perjury statement. Some consulates or older I-134 submissions may request notarization.)
State of ____________________
County of ____________________
Subscribed and sworn (or affirmed) before me on this date.
Notary / Officer Signature and Seal: ______________________________________________
Additional Sponsor Declarations
- The Sponsor agrees to provide any additional evidence or information requested by USCIS, the Department of State, or any other government agency.
- The Sponsor understands that providing false information may result in denial of the immigration benefit, criminal prosecution, civil penalties, and liability for reimbursement of public benefits.
- The Sponsor has not received any payment or other consideration for executing this Affidavit.
Key Information Summary Table
| Item | Value |
|-----------------------------------|--------------------------------------------|
| Sponsor Full Name | [[Sponsor Full Name]] |
| Sponsor Address | [[Sponsor Address]] |
| Sponsor Annual Income | [[Sponsor Annual Income]] |
| Household Size | [[Household Size]] |
| Beneficiary Full Name | [[Beneficiary Full Name]] |
| Beneficiary Relationship | [[Beneficiary Relationship to Sponsor]] |
| Visa Category | [[Visa Category]] |
| USCIS Form Type | [[USCIS Form Type]] |
Exhibit A - List of Attached Evidence
(Attach and list tax returns, pay stubs, asset statements, proof of status, and any joint sponsor documents here.)
- ________________________________________________
- ________________________________________________
- ________________________________________________
Disclaimer
This Affidavit of Support is a sample template for use in connection with USCIS immigration filings. It addresses key requirements for I-864 (family-based and certain employment-based immigrants under INA §213A) including the 125% of HHS Federal Poverty Guidelines income threshold (100% for active-duty military sponsors of spouse or child), household size definition, enforceable contractual support obligation lasting until naturalization or 40 qualifying work quarters, requirement for supporting evidence such as tax returns and proof of income, joint sponsor option, and the recommendation for attorney or accredited representative review. It also covers I-134 contexts for nonimmigrants.
USCIS forms, instructions, and poverty guidelines are updated periodically. The Sponsor must use the current official USCIS forms and the most recent I-864P poverty guideline table. This template is for informational and illustrative purposes only and is not a substitute for legal advice. Requirements, interpretations, and eligibility criteria may change. The Sponsor should consult a qualified immigration attorney or accredited representative and verify all information against official USCIS and Department of State sources before submission. Information is current as of June 2026.
