Affidavit of Financial Support and Intent to Petition for Legal Custody for Public Law 97-359 Amerasian

• Legal Form Number: I-361
• Section: Citizenship and Immigration Services (United States of America)
• Issuer: Citizenship and Immigration Services (United States of America)

Form I-361 09/11/15 N Page 1 of 8

Affidavit of Financial Support and Intent to Petition for Legal

Custody of Public Law 97-359 Amerasian

Department of Homeland Security

U.S. Citizenship and Immigration Services USCIS

Form I-361

►START HERE - Type or print in black ink.

Part 1. Information About You (Sponsor)

1.a. Family Name

(Last Name)

1.b. Given Name

(First Name)

1.c. Middle Name

2. Date of Birth (mm/dd/yyyy)

3.a. City

of Birth

U.S. Social Security Number (if any)5.

►

USCIS ELIS Account Number (if any)6.

►

Physical Address

7.c.

7.d.

7.a.

7.b.

7.g.

7.h.

7.f.

Mailing Address

In Care of Name

A-

►

Alien Registration Number (A-Number) (if any)4.

3.b. Country

of Birth

Information About Citizenship

10. Are you a U.S. citizen? Yes No

How did you acquire your U.S. citizenship?11.

Birth Parents Naturalization

12.a. If you acquired your U.S. citizenship through your

parents, have you obtained a Certificate of Citizenship in

your own name? Yes No

If you answered "Yes," provide the following information

about your Certificate of Citizenship:

Name Under Which the Certificate of Citizenship Was

Issued

Family Name

(Last Name)

Given Name

(First Name)

Middle Name

12.c. Certificate of Citizenship Number

12.d.

12.b.

9.c.

9.d.

9.a.

9.b.

9.g.

9.h.

9.e.

9.i.

8. Are your physical address and mailing address the same?

Yes No

If you answered "No" to Item Number 8., provide your

mailing address in Item Numbers 9.a. - 9.i.

Other

Date of Issuance (mm/dd/yyyy)

12.e. Place of Issuance

City or Town

State 9.f. ZIP Code

Postal Code

Province

Country

Street Number

and Name

Apt. Flr.Ste.

City or Town

State 7.e. ZIP Code

Postal Code

Province

Country

Street Number

and Name

Apt. Flr.Ste.