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Department of Homeland Security. U.S. Citizenship and Immigration Services. 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:
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.
Government with his or her application for an immigrant visa or adjustment of status, under INA section 213A, these actions create a contract between you and the U.S. Government. The intending immigrant becoming a lawful permanent resident is the consideration for the contract.
the Form I-864 I executed and on this Form I-864A applies for a means-tested public benefit, including Medicaid, the Children's Health Insurance Program, Temporary Assistance to
Department of Homeland Security. U.S. Citizenship and Immigration Services. USCIS. Form I-864A. OMB No. 1615-0075 Expires 03/31/2020. 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:
Form I-864A, Contract Between Sponsor and Household Member, is an attachment to Form I-864, Affidavit of Support Under Section 213A of the Immigration and Nationality Act (the Act). The sponsor enters the information above, complete Part 2 of this form, and signs in Part 5.
section of the Form I-864A Instructions before completing this part. Promise to provide any and all financial support necessary to assist the sponsor in maintaining the sponsored immigrants at or above the minimum income provided for in section 213A(a)(1)(A) of the Immigration and Naturalization Act (INA) (not less