Uz sve podatke koje davalac Affidavita unosi u obrazac, potpisuje izmedju ostalog i sljedece:
"This affidavit is made by me for the purpose of assuring the U.S. Government that the person(s) named initem (3) will not become a public charge in the United States.
I am willing and able to receive, maintain and support the person(s) named in item 3. That I am ready and willing todeposit a bond, if necessary, to guarantee that such person(s) will not become a public charge during his or her stay in theUnited States, or to guarantee that the above named person(s) will maintain his or her nonimmigrant status, if admitted temporarilyand will depart prior to the expiration of his or her authorized stay in the United States.
I understand this affidavit will be binding upon me for a period of three (3) years after entry of the person(s) named initem (3) and that the information and documentation provided by me may be made available to the Secretary of Health and HumanServices and the Secretary of Agriculture, who may make it available to a public assistance agency."
Kompletan obrazac se nalazi na
http://www.uscis.gov/files/form/I-134.pdf