Form I-361 - Affidavit Of Financial Support And Intent To Petition For Legal Custody Page 2
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11The Secretary of Health and Human Services and the
Sponsor and Alien Liability
Secretary of Agriculture are authorized to obtain copies
of any documentation of this type submitted to USCIS or
Public Law 97-359 provides that the Secretary of Homeland
the Department of State and release this documentation
Security may seek to enforce this guarantee of financial support
to a State public assistance agency.
and intent to petition for legal custody with respect to the
Sections 1621(c) and 415(d) of the Social Security Act
Amerasian against you in a civil suit in the U.S. district court for
and 5(i) of the Food Stamp Act also provide that an alien
the district in which you reside. However, you or your estate
and his or her sponsor will be "jointly and severably"
will not be liable under this guarantee if you die or are
liable to repay any SSI, AFDC, or food stamps benefits
adjudicated as bankrupt under Title 11, United States Code.
that are incorrectly paid because of misinformation
provided by a sponsor or because of a sponsor's failure to
If the Amerasian is under 18 years of age, you are responsible
provide information. This means the sponsor would be
for interim costs incurred by the Amerasian from the time he or
fully responsible if the alien is unable to pay.
she is released for emigration by his or her mother or legal
Incorrect payments that are not repaid will be withheld
guardian until you are awarded legal custody of the Amerasian.
from any subsequent payments for which the alien or
Furthermore, while all health costs incurred by the Amerasian
sponsor are otherwise eligible under the Social Security
are your responsibility, you should be aware that some health
or Food Stamp Acts, except where the sponsor was
insurance policies may not cover persons who are not members
without fault or where good cause existed.
of the policy holder's immediate family.
The provisions do not apply to the SSI, AFDC, or food
Effective October 1, 1980, amendments to section 1614(f) of the
stamp eligibility of aliens admitted as refugees or granted
Social Security Act and Part A of Title XVI of the Social
asylum, and of dependent children of the sponsor's
Security Act establish certain requirements for determining the
spouse. The provisions also do not apply to the SSI
eligibility of aliens who apply for the first time for Supplemental
eligibility for an alien who becomes blind or disabled
Security Income (SSI) benefits.
after admission to the United States for permanent
residence.
Effective October 1, 1981, amendments to section 415 of the
USCIS Forms and Information
Social Security Act establish similar requirements for
determining the eligibility of aliens who apply for the first time
To order USCIS forms, call our toll-free number at
for Aid to Families with Dependent Children (AFDC) benefits.
1-800-870-3676. You can also get USCIS forms and
information on immigration laws, regulations, and procedures
Effective December 22, 1981, amendments to the Food Stamp
by telephoning our National Customer Service Center at
Act of 1977 affect the eligibility of alien participation in the
1-800-375-5283 or visiting our Internet Web site at
Food Stamp Program.
As an alternative to waiting in line for assistance at your local
These amendments require that the income and resources for
USCIS office, you can now schedule an appointment through
any person who, as the sponsor of an alien's entry into the
our Internet-based system, InfoPass. To access the system,
United States, executed an affidavit of support or similar
visit our Web site. Use the InfoPass appointment scheduler
agreement on behalf of the alien, and the income and resources
and follow the screen prompts to set up your appointment.
of the sponsor's spouse (if living with the sponsor) will be
InfoPass generates an electronic appointment notice that
considered as the income and resources of the alien under
appears on the screen.
formulas for determining eligibility for SSI, AFDC, and food
stamp benefits during the three years following the alien's entry
Penalties
into the United States.
If you knowingly and willfully falsify or conceal a material
An alien applying for SSI must make available to the Social
fact or submit a false document with Form I-361, we will deny
Security Administration documentation concerning his or her
your Form I-361 and may deny any other immigration benefit.
income and resources and those of the sponsor, including
information that was provided in support of a petition for
In addition, you will face severe penalties provided by law and
immigration benefits. An alien applying for AFDC or food
may be subject to criminal prosecution.
stamps must make similar information available to the State
This will not be accepted if more than a year has elapsed from
public assistance agency.
the date of execution.
Form I-361 (Rev. 04/28/09)Y Page 2
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