Form I-864A Instructions (Rev. 01/15/06)N Page 2
If you are the intending immigrant and the sponsor is
including your income on Form I-864 to meet the eligibility
requirements, you need to complete this form only if you have
accompanying dependents. If you are the intending
immigrant and the sponsor is including only your assets on
Form I-864, you do not need to complete this form, even if
you have accompanying dependents.
If the Intending Immigrant Is a Household
Member, Must He or She Complete This Form?
This form is divided into three parts. The sponsor completes
Part 2 of this form and gives it to the household member. The
household member completes Parts 1 and 3 of this form. The
information below gives detailed information on completing
this form. The Privacy Act Notice and information on
penalties for misrepresentation or fraud are included on the
instructions to Form I-864.
If you, the household member, are also the sponsored
immigrant, check box (a) or (b) as applicable.
If you check box (a) (married to the sponsor), you do not
have to reside with the sponsor, but you must provide
proof that your income will continue from the same
source after immigration. If you check box (b) (not
married to the sponsor), you must provide proof that you
currently have the same principal residence as the sponsor
and that your income will continue from the same source
Household Member's Relationship to the Sponsor.
Household Member's Federal Income Tax
Do not submit copies of your State income tax returns.
Do not submit any tax returns that you filed with any
foreign government unless you are claiming that you were
not required to file a Federal tax return with the United
States government and you wish to rely on the foreign
return solely to establish the amount of your income that
was not subject to tax in the United States.
Part 1. Information on the Household Member.
If you are the household member completing this form,
but are not the intending immigrant, check box (c), and
check the box below that describes your relationship to
the sponsor. If you check "dependent," you must be listed
as a dependent on the sponsor's most recent Federal tax
return. You do not have to provide proof that you have
the same principal residence as the sponsor. If you check
any other relative except for spouse, you must provide
proof of the relationship and that you have the same
principal residence as the sponsor.
You may include evidence supporting your claim about
your expected income for the current year if you believe
that submitting this evidence will help you establish
ability to maintain sufficient income. You are not
required to submit this evidence, however, unless
specifically instructed to do so by a Government
official. For example, you may include a recent letter
from your employer, showing your employer's address
and telephone number, and indicating your annual salary.
You may also provide pay stub(s) showing your income
for the previous six months. If your claimed income
includes alimony, child support, dividend or interest
income, or income from any other source, you may also
include evidence of ability to maintain that income.
You must provide either an IRS transcript or a photocopy
from your own records of your Federal individual income
tax return for the most recent tax year. If you believe
additional returns may help you to establish your ability to
maintain sufficient income, you may submit transcripts or
photocopies of your Federal individual income tax returns
for the three most recent years.
You are not required to have the IRS certify the transcript
or photocopy unless specifically instructed to do so by a
Government official; a plain transcript or photocopy is
acceptable. Telefile tax records are not acceptable proof
Check all boxes that apply to you. A sponsor may not
rely on a household member's income from illegal
activities, such a proceeds from illegal gambling or drug
sales, to meet the income requirements, even if the
household member paid taxes on that income.
Household Member's Employment.
Current Individual Annual Income.
Enter your current individual earned or retirement annual
income that you are using to meet the requirements of this
form and indicate the total on this line.
If you provide a photocopy of your tax return(s), you
must include a copy of each and every FormW-2 and
Form 1099 that relates to your return(s). Do not include
copies of these Forms if you provide an IRS transcript of
your return(s) rather than a photocopy.
If you checked box 9(b) (self-employed), you should have
completed one of the following forms with your Federal
income tax return: Schedule C (Profit or Loss from
Business), Schedule D (Capital Gains), Schedule E
(Supplemental Income or Loss) or Schedule F (Profit or
Loss from Farming). You must include each and every
Form 1040 Schedule, if any, that you filed with your
Federal tax return.