OMB No. 1615-0022; Exp. 09/30/2012 Form I-363, Request to Enforce Affidavit of Financial Support and Intent to Petition for Legal Custody for P. L. 97-359 Amerasian Department of Homeland Security U.S. Citizenship and Immigration Services Type or print in black ink. - See instructions on reverse side. 1. Beneficiary's Family Name (Capital Letters) First Name Middle Name 3. Mailing Address in U.S. (Number, Street, Apt.) C/O: 4. Employer or School (Name and Address (City) 2. Alien Registration Number A(State) (Zip Code) 5. Country of Citizenship 6. Date of Birth (mm/dd/yyyy) 7. Place of Birth (City or Town) (Province or State) (Country) 8. Applicant's Phone Number (Include Area Code) 9. Initially Admitted to U.S. at (City and State) 10. Beneficiary's Relationship to Sponsor 11. Destination in U.S. at Time of Initial Admission 12. Beneficiary's file is at USCIS office in (City and State) 13. Sponsor's Family Name (Capital Letters) First Name Middle Name U.S. Citizen Lawful Permanent Resident 14. Sponsor's Present Address 15. Sponsor's Employer Sponsor's Phone Number (Include Area Code) 16. Does the beneficiary live with the sponsor? 17. If not, with whom does the beneficiary live? Yes No 18. How is the beneficiary supported? (Sponsor? Other Sources?) How long has the applicant been supported by the sponsor? 19. Is the beneficiary in the legal custody of the sponsor? 20. Has the sponsor stopped all support? Yes No Yes No 21. Has the sponsor give any reason for withdrawal of support? Yes No (Explain) Since when? (mm/dd/yyyy) If "Yes," describe the circumstances under which the sponsor ceased his or her support. NOTE: Attach a copy of Form I-361, Affidavit of Financial Support and Intent to Petition for Legal Custody for P. L. 97-359 Amerasian, if available. 22. Relationship of Applicant Self Representative of the Agency Having Legal Custody of the Beneficiary Individual Having Legal Custody of the Beneficiary Guardian Ad Litem 23. Signature and Date of Person Preparing Form, If Other Than Applicant 24. Signature of Applicant and Date Do Not Write Below This Line. ACTION BLOCK (For use by USCIS officer) This applicant was interviewed by me on in person by phone at (Date) Remarks: (Place) Investigation Completed on Investigation Not Necessary (Date) (Signature and Title) Recommendation Forwarded to U.S. Attorney Enforcement Recommended No Action Recommended (Regional Counsel and Region) Received Date: Trans In Ret'd Trans Out Completed Form I-363 (09/15/11) Y American LegalNet, Inc. www.FormsWorkFlow.com