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I-134A Application Form

I-134A, Declaration of Financial Support

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I am filing this form on behalf of
Beneficiary's Current Legal Name (Do not provide a nickname.)
Other Names Used
Gender
Place of Birth
Marital Status
>> Beneficiary's Mailing Address
Are the beneficiary's mailing address and physical address the same?
>> Beneficiary's Anticipated Period of Stay in the United States
End Date
>> Beneficiary's Financial Information

Provide information about the beneficiary's income and assets. If you need additional space to complete any Item Number in this section

Does any of the beneficiary's total income (including income from dependents and other individuals who contribute to the beneficiary's income, excluding any individuals named ) come from an illegal activity or source (such as proceeds from illegal gambling or illegal drug sales)?
>> Beneficiary's Assets
>> Information About the Individual Agreeing to Financially Support the Beneficiary Named
Current Legal Name
Other Names Used
Current Mailing Address
What is your current immigration status?
Evidence
  • Work Letter
  • Bank Letter
  • Income Tax
  • Assets
  • Immigration Status (Green Card, Citizenship, Work Authorization Card)
  • Passport Front Page
  • Beneficiary Assets If Any

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