The Form I-864A, Contract Between Sponsor and Household Member, is a legally binding contract between the primary sponsor, a household member, and the U.

S.

Government.

This form is required when the primary sponsor's income alone, as reported on Form I-864, is not sufficient to meet the minimum income requirements (125% of the Federal Poverty Guidelines) for the intending immigrant and their family.

By signing Form I-864A, the household member agrees to make their income and/or assets available to the primary sponsor to support the intending immigrant.

This commitment makes the household member jointly and severally liable with the sponsor for the financial support of the intending immigrant.

This form must be filed together with the main Form I-864.

Key Requirements:

• Financial Contribution: The household member must agree to make their income and/or assets available to the sponsor and the intending immigrant. This income is then combined with the primary sponsor's income to meet the poverty guidelines.
• Household Definition: The household member must be at least 18 years old, reside with the sponsor, and be a relative (spouse, parent, adult child, sibling) or a documented dependent on the sponsor's most recent tax return.
• Joint Responsibility: The household member assumes joint and several liability with the sponsor, meaning they share the legal financial obligation. This obligation usually lasts until the immigrant becomes a U.S. citizen or has worked for 40 quarters (approximately 10 years) in the U.S.
• Documentation: Household members must provide their most recent Federal Income Tax Return and proof of current employment or income.

Instructions for Use:

This digital template helps you generate a structured summary and draft of the I-864A details.

It is intended for preparation purposes.

The final version must be completed accurately and filed through the official USCIS channels *along with* Form I-864, Affidavit of Support.