ZHANG, BUSH, GAO & ASSOCIATES, P



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Information/Documents Needed for

Affidavit of Financial Support (I-864)

Required Documents

1. Most recent three (3) years tax return forms

2. Most recent three (3) years W-2 or 1099 forms

3. Letter from employer confirming the employment and salary

4. Evidence of ownership of assets, such as real estate, stock, saving deposit

5. If you have previously filled Form I-864 for others, please provide a copy if it is available

Information Sheet

Part 1. Information on Sponsor:

1. Last Name _____________ First Name ____________ Middle Name _____

2. Date of Birth __________

3. Place of Birth __________

4. Are you a U.S. Citizen Yes____ No_____

5. Social Security Number ________________

6. A-Number ________________________

7. You have been in the U.S. since ______________

8. Mailing Address:

Street Address________________________ Apt. No. ________

City___________________ State/Province_______________ Country_______

Zip/Postal Code_______

Telephone number __________________

9. Place of Residence if Different from the Mailing Address

Street Address________________________ Apt. No. _______

City___________________ State/Province_______________ Country_______

Zip/Postal Code_______

Telephone number __________________

Part 2. Information on the Immigrant

1. Last Name __________ First Name______________Middle Name_________

2. Date of Birth ________________

3. Sex: Male____ Female_____

4. Marital Status: Married ____ Single______ Widowed_______ Divorced_______

5. Social Security Number ________________________

6. Country of Citizenship __________________________

7. A-number _____________

8. Current Address:

Street Address________________________ Apt. No. ________

City___________________ State/Province_______________ Country_______

Zip/Postal Code_______

Telephone number __________________

9. If there are any children immigrates with the above named immigrant, please provide the information of children below:

|Name |Relationship to the |Date of Birth |A-Number |Social Security Number |

| |Immigrant | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

Part 3. Sponsor’s Eligibility

1. Sponsor’s Employer _____________________________

2. Annual Salary____________________________ or hour wage at ___________

3. If self-employed provide

a. Name of Business ________________

b. Nature of Business _______________

4. If unemployed or retired, please give the date unemployment or retirement started________

5. How many persons (related to you by birth, marriage, or adoption) live in your residence (including yourself) ________________

6. Have you ever previously sponsored any immigrants using Form I-864 who is now NOT live in your residence? Yes____ No_____ if yes, How many __________

7. Are there any persons who are dependent on you but not live in your residence?

Yes_____ No ____ if yes, how many _________

8. Give the information about all persons for whom you have previously filled Form I-864

|Name |A-Number |Date of Form I-864 Signed |Relationship to You |

| | | | |

| | | | |

| | | | |

9. About Sponsor’s Assets

a. Saving Deposit $________________

b. Stocks, bonds, certificates of deposit $__________________

c. Life Insurance cash value $__________________

d. Real Estates $_____________

e. Other (specify the assets) ______________ at value of $_________

Total Cash Value of Assets $__________________

(Please provide evidence for all the assets listed above)

10. I have lived in the United States since _________(Date)

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