Fillable Form I-864A (2019)

What is Form I-864A?

Form I-864A is an attachment to Form I-864, Affidavit of Support, under Section 213A of the Immigration and Nationality Act (INA).

In the event that a citizen or lawful permanent resident residing in the United States wishes to petition for a family member to immigrate to the United States, they would need to accomplish and file Form I-864. The purpose of the form, basically, is to provide proof that the potential immigrant is financially able to live in the United States.

If proven that the U.S.-based citizen or lawful permanent resident does not reach the income requirement set by the U.S. Citizenship and Immigration Services (USCIS), they would need to accomplish Form I-864A.

Form I-864A or the “Contract between Sponsor and Household Member” serves the purpose of being an agreement between the sponsor of a potential U.S. immigrant and another household member financially able and willing to support the potential immigrant. Upon completion of Form I-864A, the Household Member grants permission for their income to be used by the sponsor of the potential immigrant to meet the USCIS’s financial requirements.

Form I-864A is used when the sponsor and their respective household cannot live or earn enough income to live at or above 125% of the United State’s poverty line. The form also serves as a joint and several liability between sponsors, making them responsible for their own financial obligations in the effort to reach the amount the government would be asking of them for the potential immigrant.

Who should fill out Form I-864A?

The sponsor and a financially able household member should be the ones completing and signing each Form I-864A. They should be of legal age, at least eighteen (18) years-old.

What is the purpose of Form I-864A?

Upon completion and the signing of Form I-864A, the form acts and serves as a contract of agreement between the sponsor and financially-able household member that the household member is allowing their income to be used for the immigration process of the intending U.S. immigrant.

It should be noted that this form can only be used if and only if the sponsor’s income does not enable them to live at or above 125% of the poverty line and meet the other requirements set by the USCIS, and if the household member agrees.

The household member’s obligations written on this contract will be annulled only when the sponsor’s obligations, found in Form I-864, are annulled too.

Form I-864A must be submitted together with Form I-864; do not submit them separately.

Where to file Form I-864A?

For U.S. Postal Service (USPS):

USCIS

P.O. Box 805887

Chicago, IL 60680-4120

For FedEx, UPS, and DHL deliveries:

USCIS

Attn: FBAS

131 South Dearborn - 3rd Floor

Chicago, IL 60603-5517

Do review and check if the necessary signatures have been affixed because forms without the needed signatures will be rejected.

How to fill out Form I-864A?

Form I-864A consist of six (6) parts. Begin at where the marking “START” is written.

Part 1 – The household member information

Legibly and accurately, provide the following information regarding the household member’s background with black ink/color.

• Item 1. Household member's full name.
• Item 2. Household member’s full and current mailing address
• Item 3. If the mailing address is the same as the household member’s physical address, tick the box that says “yes” and “no” if it isn’t.
• Item 4. If the household member chose “no” in item 3, type/print your physical address in the space provided.
• Item 5. Household member’s birth date written using the mm/dd/yyyy format
• Item 6. Household member’s place of birth.
• Item 7. Household member’s Social Security number, but only if they have one.
• Item 8. Enter here household member’s USCIS online account number. The household member can access the number by logging into their USCIS account.

Part 2 – Explaining the relationship between household member and sponsor

• Item 1.
  With the options provided, choose the box that best relates or describes the household member’s relationship with the sponsor.

Part 3 – Provide information regarding the household member’s employment and income

• Items 1-6.
  In Part 3 of the form, the household member should provide accurate information about their employment status such as their current job title, the name of their current employer, and honestly report if they are self-employed, retired, or unemployed.

Part 4 – Provide household member’s Federal income tax information and assets

• Items 1-3.
  In Part 4 of the form, the household member must report their total adjusted gross income from their three most recent federal income tax returns with the corresponding tax years noted. They may also provide the total value of any assets, such as bank account balances, cash value of any real estate they own, cash value of stocks, bonds, certificates of deposit, and any other assets.

Part 5 – Declare the sponsor’s promise, statement, contact information, declaration, certification, and signature

In Part 5 of the form, the sponsor should be able to report the number of potential immigrants they intend to sponsor.

Some general information the sponsor should be able to report to the government about the potential immigrant/s is their full name/s, date of birth, Alien Registration numbers, Social Security numbers, USCIS online account numbers, contact information, and their signature/s to name a few.

Part 6 – Declare household member’s promise, statement, contact information, declaration, certification, and signature

Like Part 5 of the form, Part 6 focuses on the household member and should contain the household member’s full name, the full name/s of the potential immigrants written in Part 5, the household member’s contact information, their signature, and report if an interpreter was involved in any part of accomplishing the form.

Some other details and instructions to take note of when accomplishing Form I-864A:

• If an interpreter was involved in the completion of the form, that interpreter must fill out Part 7 of the form.
• If a preparer accomplished the form, the preparer must complete Part 8.
• If the spaces and blanks provided in any part of the form are insufficient, the individual filling out information may use section 9 to complete their answers.
• Signatures are required to be done using black ink; printed or stamped signatures will not be accepted.