Fill - Petition for Legal Custody of P.L. 97-359 Amerasian (ILW.COM)

Department of Homeland Security

U. S. Citizenship and Immigration Services

I -361, Affidavit of Financial Support and Intent to

Petition for Legal Custody of P.L. 97-359 Amerasian

OMB No. 1615-0021; Expires 03/31/09

Instructions

What Is the Purpose of This Form?

This affidavit may be used only to sponsor persons born in

Korea, Laos, Vietnam, Kampuchea and Thailand after

December 31, 1950 and before October 22, 1982, who were

fathered by U.S. citizens. It must be filed in support of Form

I-360, Petition for Amerasian, Widow(er) or Special

Immigrant.

Sponsor Eligibility.

In order to sponsor a Public Law 97-359 Amerasian, you

must be a U.S. citizen or lawful permanent resident 21 years

of age or older, and of good moral character.

On the date the Amerasian acquires the status of an alien

lawfully admitted for permanent residence, or

Financial Sponsorship Requirements.

The financial support must be sufficient to maintain your

family, including the Amerasians in the United States, at a

level equal to at least 125 percent of the current official

poverty line (as established by the Director of the Office of

Management and Budget, under section 673(2) of the

Omnibus Budget Reconciliation Act of 1981 and as revised

by the Secretary of Health and Human Services under section

652 of that Act) for a family of the same size as your family

including the Amerasian.

Special Sponsorship Requirement.

You must agree to petition the court having jurisdiction

within 30 days of the Amerasian's arrival in the United States

to be awarded legal custody in accordance with the laws of

the state where the Amerasian will reside until the Amerasian

is 18 years of age.

Execution of Affidavit.

Form I-361 (Rev. 03/17/06)Y

You must sign the affidavit in your full, true and correct

name and affirm or make it under oath.

If you are in the United States, the affidavit must be sworn to

or affirmed before a USCIS Officer.

You must submit in duplicate evidence of income and

resources, as appropriate:

Statement of your employer, preferably on business

stationery, showing:

If you are outside the United States, the affidavit must be

sworn to or affirmed before a USCIS Officer or a U.S

Department of State Consular Officer.

Supporting Evidence.

Statement from an officer of the bank or other financial

institution in which you have deposits, giving the

following details regarding you account:

Date the account was opened.

Present balance.

Dates and nature of employment.

Whether position is temporary or permanent.

Copy of last income tax return filed or,

Report of commercial rating concern.

If you are self-employed:

List containing the serial numbers and denominations of

bonds and name(s) of record of the owner(s).

You must furnish financial support during the entire five-year

period, beginning:

During the entire period, beginning on the date the

Amerasian acquires the status of an alien lawfully

admitted for permanent residence and ending on the date

when the Amerasian becomes 21 years of age, whichever

period is longer.

Please see the instructions on Form I-360 concerning

placement of a beneficiary under 18 years old.

In addition, an appropriate public, private or state agency

must arrange the Amerasian's placement with you in the

United States, and you must be able to accept the Amerasian

for care in you home under the laws of the state of the

Amerasian's intended residence.

The sponsor must complete, sign and submit this form in

duplicate with Form I-360 to the district or suboffice of U.S

Citizenship and Immigration Services (USCIS) that has

jurisdiction over the sponsor's place of residence. Failure to

submit this form in duplicate may result in the rejection of

your petition.

Salary paid.

Total amount deposited for the past year.

Form I-361 (Rev. 03/17/06)Y Page 2

If the Amerasian is under 18 years of age, you are responsible

for interim costs incurred by the Amerasian from the time he or

she is released for emigration by his or her mother or legal

guardian until you are awarded legal custody of the Amerasian

Furthermore, while all health costs incurred by the Amerasian

are your responsibility, note that some health insurance policies

may not cover persons who are not members of the policy

holder's immediate family.

Effective October 1, 1980, amendments to section 1614 (f) of

the Social Security Act and Part A of Title XVI of the Social

Security Act establish certain requirements for determining the

eligibility of aliens who apply for the first time for Supplemental

Security Income (SSI) benefits.

Effective October 1, 1981, amendments to section 415 of the

Social Security Act establish similar requirements for

determining the eligibility of aliens who apply for the first time

for Aid to Families with Dependent Children (AFDC) benefits.

Effective December 22, 1981, amendments to the Food Stamp

Act of 1977 affect the eligibility of alien participation in the

Food Stamp Program.

These amendments require that the income and resources for

any person who, as the sponsor of an alien's entry into the

United States, executed an affidavit of support or similar

agreement on behalf of the alien, and the income and resources

of the sponsor's spouse (if living with the sponsor) will be

deemed to be the income and resources of the alien under

formulas for determining eligibility for SSI, AFDC and food

stamp benefits during the three years following the alien's entry

into the United States.

An alien applying for SSI must make available to the Social

Security Administration documentation concerning his or her

income and resources and those of the sponsor, including

information that was provided in support of a petition for

immigration benefits. An alien applying for AFDC or food

stamps must make similar information available to the state

public assistance agency.

The provisions do not apply to the SSI, AFDC or food

stamp eligibility of aliens admitted as refugees or granted

asylum, and of dependent children of the sponsor's

spouse. The provisions also do not apply to the SSI

eligibility for an alien who becomes blind or disabled

after admission to the United States for permanent

residence.

Incorrect payments that are not repaid will be withheld

from any subsequent payments for which the alien or

sponsor are otherwise eligible under the Social Security

or Food Stamp Acts, except where the sponsor was

without fault or where good cause existed.

Authority, Use and Penalties.

Authority for the collection of the information requested

on this form is contained in 8 U.S.C. 1154(g) and 1182

(a)(15).

The information will be used principally by USCIS, or by

any officer to whom it may be furnished, to support a

petition for benefits under the Immigration and

Nationality Act in behalf of a Public Law 97-359

Amerasian. It may also, as a matter of routine use, be

disclosed to other Federal, state, local and foreign law

enforcement and regulatory agencies. Submission of the

information is voluntary. Failure to provide the

information may result in the denial of benefits to the

Amerasian.

This affidavit must be of recent date. The affidavit will

not be accepted if more than a year has elapsed from the

date of execution.

Sections 1621(c) and 415(d) of the Social Security Act

and 5(i) of the Food Stamp Act also provide that an alien

and his or her sponsor will be jointly and severably liable

to repay any SSI, AFDC or food stamps benefits that are

incorrectly paid because of misinformation provided by a

sponsor or because of a sponsor's failure to provide

information.

The Secretary of Health and Human Services and the

Secretary of Agriculture are authorized to obtain copies

of any documentation of this type submitted to USCIS or

the Department of State and release this documentation

to a state public assistance agency.

Public Law 97-359 provides that this guarantee of financial

support and intent to petition for legal custody may be enforced

with respect to the Amerasian against you in a civil suit brought

by the Secretary of Homeland Security in the United States

district court for the district in which you reside, except that you

or your estate will not be liable under this guarantee if you die or

are adjudicated as bankrupt under Title 11, United States Code.

Sponsor and Alien Liability.

Form I-361 (Rev. 03/17/06)Y Page 3

Use InfoPass for Appointments.

As an alternative to waiting in line for assistance at your local

USCIS office, you can now schedule an appointment through

our internet-based system, InfoPass. To access the system, visit

our website at www.uscis.gov. Use the InfoPass appointment

scheduler and follow the screen prompts to set up your

appointment. InfoPass generates an electronic appointment

notice that appears on the screen. Print the notice and take it

with you to your appointment. The notice gives the time and

date of your appointment, along with the address of the USCIS

office.

A person is not required to respond to a collection of

information unless it displays a currently valid OMB control

number.

Reporting Burden.

Public reporting burden for this collection of information is

estimated to average 30 minutes per response, including the time

for reviewing instructions, searching existing data sources

gathering and maintaining the data needed, and completing and

reviewing the collection of information.

Send comments regarding this burden estimate or any other

aspect of this collection of information, including suggestions

for reducing this burden to: U.S. Citizenship and Immigration

Services, Regulatory Management Division, 111 Massachusetts

Avenue, N. W., Washington, DC 20529; OMB No. 1615-0021

Do not mail your completed application to this address.

To order USCIS forms call our toll-free forms line at

1-800-870-3676. You can also get USCIS forms and

information on immigration laws, regulations and procedures by

telephoning our National Customer Service Center at

1-800-375-5283 or visiting our intenet website at

www.uscis.gov.

USCIS Forms and Information.

Form I-361 (Rev. 03/17/06)Y

NOTE: Use only to sponsor a Public Law 97-359 Amerasian. (Answer all items. Type or print legibly in black ink.)

Being Duly Sworn Depose and Say:

residing at

(Name)

(Street and number)

(City) (State) (Zip Code if in U.S.)

(Country)

1. That I was born on

(Date) (City) (Country)

If you are not a native born U.S. citizen, answer the following as appropriate:

If a U.S. citizen through naturalization, give certificate of naturalization number

If a U.S. citizen through parent(s) or marriage, give citizenship certificate number

That I am years of age and have resided in the United States since (date)

That this affidavit is executed on behalf of the following person:

Name Gender Date of Birth (mm/dd/yyyy)

Born in (Country) Alien Registration Number Marital Status

Presently Resides at: (Street and Number) (City) (State) (Country)

That this affidavit is made by me for the purpose of assuring the U.S. Government that the person named in item 3 will not

become a public charge in the United States.

That I am willing and able to receive, maintain and support the person named in item 3 and that I agree to furnish financial

support during the entire five-year period beginning on the date the named person acquires the status of an alien lawfully

admitted for permanent residence and ending on the date on which the named person becomes 21 years of age, whichever period

is longer. The financial support which I furnish must be sufficient to maintain my family, including the named person in the

United States, at a level equal to at least 125 percent of the current official poverty line (as established by the Director of the

Office of Management and Budget, under Section 673(2) of the Omnibus Budget Reconciliation Act of 1981 and as revised by

the Secretary of Health and Human and Services under section 652 of that Act) for a family size as my family, including the

named person.

That, if the person named in item 3 is under 18 years of age, I agree to petition the court having jurisdiction within 30 days of

the named person's arrival in the United States to be awarded legal custody in accordance with the laws of the state where he or

she will reside until he or she is 18 years of age.

Submit This Form in Duplicate.

Relationship to Deponent

If a lawfully admitted permanent resident of the United States, give "A" number

OMB No. 1615-0021; Expires 03/31/09

Department of Homeland Security

U. S. Citizenship and Immigration Services

I -361, Affidavit of Financial Support and Intent to

Petition for Legal Custody of P.L. 97-359 Amerasian

If U.S. citizenship was derived by some other method, attach a statement of explanation.

Form I-361 (Rev. 03/17/06)Y Page 2

7. That, if the person named in item 3 is under 18 years of age, I agree to pay the interim costs incurred by that person from the

time he or she is released for immigration by his or her mother or legal guardian until I am awarded legal custody of him or her.

That, if the person named in item 3 is 18 years of age or older, I agree to pay the interim costs involved in his or her travel to the

United States.

That I understand that this guarantee of financial support and intent to petition for legal custody may be enforced with respect to

the person named in item 3 against me in a civil suit brought by the Secretary of Homeland Security in the United States district

court of the district in which I reside, except that I or my estate will not be liable under this guarantee if I die or am adjudicated

as bankrupt under Title 11, United States Code.

That I understand that the information and documentation provided by me may be made available to the Secretary of Health and

Human Services, the Secretary of Agriculture or the Food and Nutrition Service, who may make it available to a public

assistance agency.

10.

That I have read the instructions to this form and am aware of my responsibilities under the Social Security Act as amended, the

Food Stamp Act and Public Law 97-359.

11.

That I am employed as or engaged in the business of12.

with

(Type of Business) (Name of Concern)

(Street and Number) (City) (State) (Zip Code)

Submit This Form in Duplicate.

I derived an annual income of (if self-employed, I have

attached a copy of my last income tax return or report of

commercial rating concern which I certify to be true and

correct to the best of my knowledge and belief.)

I have on deposit in savings banks in the United States.

I have other personal property, the reasonable value of which is

I have stocks and bonds with the following market value, as

indicated on the attached list which I certify to be true and

correct to the best of my knowledge and belief.

I have life insurance in the sum of

With a cash surrender value of

I own real estate valued at

With mortgages or other encumbrances on it amounting to

Which is located at

(Street and Number)

(City)

(State) (Zip Code)

13. That the following persons are dependent upon me for support: (Place a check in the appropriate column to indicate whether

the person named is wholly or partially dependent upon you for support.)

Name of Person

Wholly

Dependent

Partially

Dependent

Age Relationship to Me

14.

That I have previously submitted or am submitting affidavit(s) of support for the following person(s). If none, state "None."

Name

Relationship

Date Submitted

15.

That I have submitted visa petition(s) to USCIS on behalf of the following person(s). If none, state "None."

Name

Relationship

Date Submitted

Oath or Affirmation of Deponent

I swear (affirm) that I know the contents of this affidavit signed by me and the statements are true and correct.

Subscribed and sworn to (affirmed) before me this

Signature of deponent

day of

Signature of immigration or consular office administering oath

Form I-361 (Rev. 03/17/06)Y Page 3

Submit This Form in Duplicate.

Title

(Date)

Address (Street Number and Name, Suite/Room, City, State, Zip Code)

(Print or Type Name)(Signature)

I declare that this document was prepared by me at the request of the deponent and it is based on all information of which I have any

knowledge.

If the affidavit was prepared by other than the deponent, please complete the following:

Telephone Number E-Mail Address (If any.)

Form I-361 (Rev. 03/17/06)Y Page 4

Submit This Form in Duplicate.

Form I-361 (Rev. 03/17/06)Y

NOTE: Use only to sponsor a Public Law 97-359 Amerasian. (Answer all items. Type or print legibly in black ink.)

Being Duly Sworn Depose and Say:

residing at

(Name)

(Street and number)

(City) (State) (Zip Code if in U.S.)

(Country)

1. That I was born on

(Date) (City) (Country)

If you are not a native born U.S. citizen, answer the following as appropriate:

If a U.S. citizen through naturalization, give certificate of naturalization number

If a U.S. citizen through parent(s) or marriage, give citizenship certificate number

That I am years of age and have resided in the United States since (date)

That this affidavit is executed on behalf of the following person:

Name Gender Date of Birth (mm/dd/yyyy)

Born in (Country) Alien Registration Number Marital Status

Presently Resides at: (Street and Number) (City) (State) (Country)

That this affidavit is made by me for the purpose of assuring the U.S. Government that the person named in item 3 will not

become a public charge in the United States.

That I am willing and able to receive, maintain and support the person named in item 3 and that I agree to furnish financial

support during the entire five-year period beginning on the date the named person acquires the status of an alien lawfully

admitted for permanent residence and ending on the date on which the named person becomes 21 years of age, whichever

period is longer. The financial support which I furnish must be sufficient to maintain my family, including the named person in

the United States, at a level equal to at least 125 percent of the current official poverty line (as established by the Director of the

Office of Management and Budget, under Section 673(2) of the Omnibus Budget Reconciliation Act of 1981 and as revised by

the Secretary of Health and Human and Services under section 652 of that Act) for a family size as my family, including the

named person.

That, if the person named in item 3 is under 18 years of age, I agree to petition the court having jurisdiction within 30 days of

the named person's arrival in the United States to be awarded legal custody in accordance with the laws of the state where he or

she will reside until he or she is 18 years of age.

Submit This Form in Duplicate.

Relationship to Deponent

If a lawfully admitted permanent resident of the United States, give "A" number

OMB No. 1615-0021; Expires 03/31/09

Department of Homeland Security

U. S. Citizenship and Immigration Services

I -361, Affidavit of Financial Support and Intent to

Petition for Legal Custody of P.L. 97-359 Amerasian

If U.S. citizenship was derived by some other method, attach a statement of explanation.

Form I-361 (Rev. 03/17/06)Y Page 2

7. That, if the person named in item 3 is under 18 years of age, I agree to pay the interim costs incurred by that person from the

time he or she is released for immigration by his or her mother or legal guardian until I am awarded legal custody of him or her.

That, if the person named in item 3 is 18 years of age or older, I agree to pay the interim costs involved in his or her travel to the

United States.

That I understand that this guarantee of financial support and intent to petition for legal custody may be enforced with respect to

the person named in item 3 against me in a civil suit brought by the Secretary of Homeland Security in the United States district

court of the district in which I reside, except that I or my estate will not be liable under this guarantee if I die or am adjudicated

as bankrupt under Title 11, United States Code.

That I understand that the information and documentation provided by me may be made available to the Secretary of Health and

Human Services, the Secretary of Agriculture or the Food and Nutrition Service, who may make it available to a public

assistance agency.

10.

That I have read the instructions to this form and am aware of my responsibilities under the Social Security Act as amended, the

Food Stamp Act and Public Law 97-359.

11.

That I am employed as or engaged in the business of12.

with

(Type of Business) (Name of Concern)

(Street and Number) (City) (State) (Zip Code)

Submit This Form in Duplicate.

I derived an annual income of (if self-employed, I have

attached a copy of my last income tax return or report of

commercial rating concern which I certify to be true and

correct to the best of my knowledge and belief.)

I have on deposit in savings banks in the United States.

I have other personal property, the reasonable value of which is

I have stocks and bonds with the following market value, as

indicated on the attached list which I certify to be true and

correct to the best of my knowledge and belief.

I have life insurance in the sum of

With a cash surrender value of

I own real estate valued at

With mortgages or other encumbrances on it amounting to

Which is located at

(Street and Number)

(City)

(State) (Zip Code)

13. That the following persons are dependent upon me for support: (Place a check in the appropriate column to indicate whether

the person named is wholly or partially dependent upon you for support.)

Name of Person

Wholly

Dependent

Partially

Dependent

Age Relationship to Me

14.

That I have previously submitted or am submitting affidavit(s) of support for the following person(s). If none, state "None."

Name

Relationship

Date Submitted

15.

That I have submitted visa petition(s) to USCIS on behalf of the following person(s). If none, state "None."

Name

Relationship

Date Submitted

Oath or Affirmation of Deponent

I swear (affirm) that I know the contents of this affidavit signed by me and the statements are true and correct.

Subscribed and sworn to (affirmed) before me this

Signature of deponent

day of

Signature of immigration or consular office administering oath

Form I-361 (Rev. 03/17/06)Y Page 3

Submit This Form in Duplicate.

Title

(Date)

Address (Street Number and Name, Suite/Room, City, State, Zip Code)

(Print or Type Name)(Signature)

I declare that this document was prepared by me at the request of the deponent and it is based on all information of which I have any

knowledge.

If the affidavit was prepared by other than the deponent, please complete the following:

Telephone Number E-Mail Address (If any.)

Form I-361 (Rev. 03/17/06)Y Page 4

Submit This Form in Duplicate.

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