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I-864A, Contract Between Sponsor and Household Member. Use this form if you are a household member and want to promise to make your income and/or assets available to help support a sponsored immigrant.
USCIS. Form I-864A. OMB No. 1615-0075 Expires 01/31/2026. For Government Use Only. This Form I-864A relates to a household member who: IS the intending immigrant. IS NOT the intending immigrant. Select this box if Form G-28 or. Reviewed By: Location: To be completed by an attorney or accredited representative (if any). Date (mm/dd/yyyy):
Form I-864A, Contract Between Sponsor and Household Member, is an attachment to Form I-864, Afidavit of Support Under Section 213A of the INA. A separate Form I-864A must be used for each household member whose income and/or assets are being used by a sponsor to qualify.
An Affidavit of Support, also called the Form I-864, is a document an individual signs to accept financial responsibility for the applicant who is coming to live in the United States. The person who signs the Affidavit of Support is also called the “sponsor.”
severally liable for any obligations I incur under the affidavit of support, promise to complete and file an affidavit of support on behalf of the following named intending immigrants.
NOTE: Read the Penalties section of the Form I-864A Instructions before completing this part. I, THE HOUSEHOLD MEMBER, , (Print Name) in consideration of the sponsor's promise to execute an affidavit of support on behalf of the above named intending immigrants. (Print number of intending immigrants noted in Part 5.
The petitioner/financial sponsor must complete and sign the appropriate Affidavit of Support form. Incomplete forms, including those missing pages, will not be accepted. The completed forms and supporting documents must be submitted in CEAC to NVC with the visa applicant’s civil documents.