
Form I-134 Edition 01/20/25 Page 7 of 10
Contact Information of Individual Agreeing to Financially Support the Beneficiary
5.
Email Address (if any)
Mobile Telephone Number (if any)4.Daytime Telephone Number3.
Certification of Individual Agreeing to Financially Support the Beneficiary
I understand that USCIS may require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or
signature) and, at that time, if I am required to provide biometrics, I will be required to sign an oath reaffirming that:
Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS or the
Department of State may require that I submit original documents to USCIS or the Department of State at a later date. Furthermore, I
authorize the release of any information from any and all of my records that USCIS or the Department of State may need to determine
my eligibility for the immigration benefit I seek.
I further authorize release of information contained in this declaration, in supporting documents, and in my USCIS or the Department
of State records, to other entities and persons where necessary for the administration and enforcement of U.S. immigration law.
1) I reviewed and provided or authorized all of the information in my declaration;
2) I understood all of the information contained in, and submitted with, my declaration; and
3) All of this information was complete, true, and correct at the time of filing.
I certify, under penalty of perjury, that I provided or authorized all of the information in my declaration, I understand all of the
information contained in, and submitted with, my declaration, and that all of this information is complete, true, and correct.
That this declaration is made by me to assure the U.S. Government that the person named in Part 3. will be financially supported
while in the United States.
That I am willing and able to receive, maintain, and support the person named in Part 3. to better ensure that such persons will have
sufficient financial resources or financial support to pay for necessary expenses for the period of his or her temporary stay in the
United States.
I acknowledge that I have read this section, and I am aware of my responsibilities as an individual agreeing to financially support the
beneficiary.
Part 5. Statement, Contact Information, Certification, and Signature of the Individual Agreeing to
Financially Support the Beneficiary
declaration for me based only upon information I provided or authorized.
2. At my request, the preparer named in Part 7., , prepared this
I can read and understand English, and I have read and understand every question and instruction on this declaration
and my answer to every question.
NOTE: Read the Penalties section of the Form I-134 Instructions before completing this section.
If you are filing Form I-134 on behalf of someone else (the beneficiary listed in Part 3.), complete and sign Part 5.
Statement of Individual Agreeing to Financially Support the Beneficiary
NOTE: Select the box for either Item A. or B. in Item Number 1. If applicable, select the box for Item Number 2.
I, as the individual agreeing to financially support the beneficiary, certify the following:
1.
A.
The interpreter named in Part 6. read to me every question and instruction on this declaration and my answer to every B.
, a language in which I am fluent and I understood question in