Sample I-134, Affidavit of Support Form
Many people have questions or doubts about how exactly to fill the I-134, Affidavit of Support form. While not absolutely mandatory, this form is highly recommended for sponsoring the visitors visa. This page describes in detail how exactly to fill sample I134. Of course, you will have to fill in your specific details and depending upon your circumstances, you may have to answer the questions differently than shown in this generic sample application.

Look at this Sample I-134 to get an idea how a typical form may look like when filled.

Step by step instructions for each field in I-134:

Part 1. Information About You (the Sponsor).

Your Full Name
1.a Family Name (Last Name): Your last name as per your passport.
1.b Given Name (First Name): Your first name as per your passport.
1.c Middle Name: If you have a middle name, write here. Otherwise, leave it blank.

Other Names Used
List all other names you have ever used, including aliases, maiden name, and nicknames. If you need extra space to complete this information, use the space provided in Part 7.

If you have not used any other names, please leave this section blank.

Sponsor's Mailing Address
In Care of Name: This can generally be left blank in most cases.

4. If your mailing address is the same as the physical address, check Yes. Otherwise, check No. For most people, it would be 'Yes'. But it is 'No' for you, you should fill 5.a through 5.h

Other Information
6. Date of Birth
Note that birth date should be written in MM/DD/YYYY format which is followed in U.S.

7a. Town or City of Birth:
Write, all the information excluding country here including Village, District, State or anything else you would like to use to identify the place.

7b. Country of Birth:
The country where you born, not necessarily the Country of your current citizenship.

8. Alien Registration Number (A-Number).
If you are a green card holder or if you ever received a work permit in the US (EAD), you have A-number. Write that down here. Otherwise, leave it blank.

9. U.S. Social Security Number.
If you have a social security number, write here. Otherwise, leave it blank.

10. USCIS Online Account Number.
If you have it, write it here. Otherwise, leave it blank.

If you have previously filed an application, petition, or request using the USCIS online filing system (previously called USCIS Electronic Immigration System (USCIS ELIS)), provide the USCIS Online Account Number you were issued by the system.

Citizenship or Residency or Status
11. Specify your legal status details in the U.S.

If you are a U.S. citizen or green card holder, provide the details accordingly.

If you are on any other status in the U.S. such as H1 visa holder, Student (F1), L1 visa holder, you can not fill any line (a) through (d). In such a case, find (e).

For those of you who are on EAD through Adjustment of Status, there is no option on the form to say that you are on EAD. So just write in one of the options on the form that you are on Adjustment of Status.

12. Write your age in completed number of years (not including running year).
Also, write the date since you have been staying in United States.

Part 2. Information About the Beneficiary.

Please write about one or more persons for whom you are sponsoring visitors visa or any other kind of visa.

If you are sponsoring both your father and mother, you can write information about your father here.

1a. Family Name:
Surname or last name. First line in name field in Indian passport.

1b. Given Name:
Given names. Second line in name field in Indian passport.

1c. Middle Name:
If you have a middle name, write here. Otherwise, you can leave it blank.

2. Date of Birth:
Note that birth date should be written in MM/DD/YYYY format which is followed in U.S.

3. Gender:
Gender of visitor. Check 'Male' or 'Female' appropriately.

4. A-Number:
Most visitors to the USA would not have this number. Therefore, they can leave it blank.

5. Country of Citizenship:
The country of citizenship for the visitor. e.g., India

6. Marital Status:
Please check the appropriate box.

7. Relationship to Sponsor:
Write appropriately such as 'Father', 'Mother', 'Father-in-law', 'brother' etc.
8. Beneficiary's Physical Address:
Write the address where the visitor is currently staying. It can be different than the one in the passport.

Beneficiary's Spouse:
If you are sponsoring both your father and mother, you can write information about your mother here.

Otherwise, leave it blank.

Beneficiary's Children:
If any minor children are going to accompanying the adult you are sponsoring, write the information about them here. Otherwise, leave that blank. For most elderly parents, this section would be blank.

However, if you are sponsoring your brother, sister-in-law and their two little children, information about those two children would go here.

Write only the names of spouse and minor children who will be accompanying or following to join the visitor to the U.S.
If you are sponsoring your parents, prepare 2 I-134 forms. In one form, write father's name as visitor and say mother will be accompanying. In the second form, write mother's name as visitor and say father will be accompanying.

Part 3. Other Information About the Sponsor.
1a. Be specific about the type of job you do. E.g., 'Software Engineer', 'IT manager', 'Insurance Agent', 'Receptionist', 'Hotel Owner', 'CPA', 'Secretary' etc.

1.a.1 Name of Employer
If you are employed somewhere, write the name of the actual employer that pays you salary. If you working at a client site as a consultant, don't write the client name as that is not your employer.

1.b. Self employed as a/an
If you have your business such as consulting service, retail business, mention that here.

Current Employer Address (if employed)
Write the address where you work or own a business.

Income and Asset Information
3. Annual Income: Write your annual income from salary, business etc. You should provide an employment letter and tax returns to prove this.

4. Balance of all my savings and checking accounts in United States-based financial institutions:
I have on deposit in savings bank in the United States: Write the amount of money you have in the bank. You can write the amount you have in checking, savings, money market, certificate of deposit (CD) etc. You should provide the bank statements to prove this.

5. Value of my other personal property:
You don't have to write the exact value to the dollars and pennies here. You can write an approximate value for cars, jewelry, land, appliances (TV, fridge, music system, cameras) and other equipment. You are not really required to provide the sales receipts or estimations of value of this property.

6. Market value of my stocks and bonds:
Self explanatory. Also attach the statement from your stock broker such as Ameritrade, ETrade that would prove this.

7a. I have life insurance in the sum of:
You can write the amount of life insurance you have, either in the U.S. or in a foreign country. You can include all types of life insurances such as term life, universal life, whole life, variable life etc.

If you don't have life insurance and would like to purchase one, visit here.

7.b. With a cash surrender value of: If you have only term life insurance, the cash surrender value is $0. Otherwise, write the appropriate value. You may ask your insurance company or insurance agent if you are not sure.

8.a. I own real estate valued at: Write the current market price of your house, if you own one. You can find it also from the last property tax bill that you have received or from neighbors who might have purchased houses in your community recently. If you don't own a house, just write $0.

8.b. I have mortgages or other debits amounting:
Just write the amount of loan you have to still pay. If you don't have a house or if your house loan is paid off, write $0.

9. Location of your house or real estate, if you have one. Else write 'N/A'.

Dependents' Information

Write the names of dependents that you include in your income tax returns. These will usually be your spouse and minor children. If your spouse is not working, you can check 'Wholly Dependent'. If your spouse is working, you can check 'Partially Dependent'.
Even if you are sending money to your parents in India every month, and they depend upon the money you send them, do not put them as dependents here.

22 through 25. Prior Affidavit of Support
If you have submitted an affidavit of support (I-134 or I-864) for anyone before, write the names and dates here.
If you are submitting multiple affidavits of support in a short duration, you have to write the names of the people for whom you submitted affidavits first in subsequent affidavits you provide, even if the first set of people have not visited the consulate yet.
E.g., Parents' interview is on Sept. 4, 2004 and in-laws' interview is on Sept. 20, 2004. And you are sending an affidavit in August 2004 for all 4 of them. In your in-laws' support form, write the names of your parents in the affidavit, because by the time your in-laws go to the consulate, your parents would have already used their affidavit.
If you submitted the affidavit for someone and even if their visa was rejected or they got a visa, but they never traveled, you have to provide their details here.
If you prepared the affidavit, but it was never used, you don't have to mention.
If you have not sponsored anyone before, write 'N/A' here.

26 through 37. Visa Petitions to USCIS
If you have submitted immigrant applications to USCIS before for anyone, write their details here.
If you are/were an H1 worker and if your H-4 spouse got included in your green card processing, and if you submitted I-134 (affidavit of support) for her during her Adjustment of Status or Consular Processing, you do NOT have to mention it here. This question is only for family based immigrant sponsorships that you initiated. And in this case, your spouse would be getting a green card on your employment basis, as your dependent.
If you have not filed any immigrant petitions for anyone, write 'N/A'.
If you have already filed immigrant petitions for someone whom you are trying to sponsor a visitor visa now, it would be very difficult to get a visitor visa for them.

38. Contributions

For tourists,
You should check the box 'I intend'.

In this case, on page 8, provide the following information:

Part 7.
3.a.
Page Number = 4
Part Number = 3
Item Number = 8

3.d. You can write something like 'All expenses including, but not limited to their visa expenses, airline return tickets costs to come to the USA & U.S. domestic travel, lodging, boarding, food, incidental expenses and visitor medical insurance.'

For other categories such as a Fiance Visa (K1 visa), write "N/A" (not applicable).

Part 4. Sponsor's Statement, Contact Information, Certification, and Signature

Sponsor's Statement

1.a. Most people would check this. However, for some, either 1.b. or 2. may be applicable.

Sponsor's Contact Information.

3. Self-explanatory. Make sure to include the area code. You can put your mobile phone number also here.
4, 5. Self-explanatory.

Sponsors' Signature
Make sure to sign and date the affidavit. Otherwise, it is not valid. There is no need to get it notarized.

Part 5. Interpreter's Contact Information, Certification, and Signature
If someone interpreted the form for you, he/she should fill this details. This can be an attorney or any other person.

Part 6. Contact Information, Statement, Declaration, and Signature of the Person Preparing this Affidavit, if Other Than the Sponsor If someone else helped you prepare this affidavit, his/her details would go there. This can be an attorney or any one else. In case of an attorney, they would have to additionally provided a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative with this application.

Part 7. Additional Information.

If you needed to provide any additional information due to lack of space in the previous answers, you can provide them here. Make sure to write Page Number, Part Number and Item Number for each information you provide.


Last Revised: 02/06/2017