Declaration of Financial Support

• Legal Form Number: I-134
• Section: Citizenship and Immigration Services (United States of America)
• Issuer: Citizenship and Immigration Services (United States of America)

Form I-134 Edition 10/18/22 Page 1 of 13

Declaration of Financial Support

Department of Homeland Security

U.S. Citizenship and Immigration Services

USCIS

Form I-134

OMB No. 1615-0014

Expires 04/30/2023

START HERE - Type or print in black ink. ►

Part 1. Basis for Filing

1.I am filing this form on behalf of:Myself as the beneficiary.

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

MaleFemale

Single, Never MarriedMarriedDivorcedWidowedLegally SeparatedMarriage Annulled

Other (Explain):

Another individual who is the beneficiary.

Part 2. Information about the Beneficiary

Complete Part 2. regardless of whether you are filing this form on behalf of yourself as the beneficiary or on behalf of another

individual who is the beneficiary.

Family Name (Last Name)Given Name (First Name)Middle Name

Beneficiary's Current Legal Name(Do not provide a nickname.)1.

Provide all other names the beneficiary has ever used, including aliases, maiden name, and nicknames. If you need extra space

to complete this section, use the space provided in Part 8. Additional Information.

Middle NameGiven Name (First Name)Family Name (Last Name)

4.Gender

A-

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Alien Registration Number (A-Number) 5.

6.Place of Birth

7.Country of Citizenship or Nationality

Marital Status

9.

Other Names Used2.

Country

State or ProvinceCity or Town

8.Passport Number of the beneficiary's most recently issued passport

Expiration date for the most recently issued passport

Country that issued the most recently issued passport

(mm/dd/yyyy)