Part 10: Contact Information, Declaration, and Signature of the Person Preparing this Affidavit, if Other Than the Sponsor
Provide the preparer's information if someone prepared this affidavit for the sponsor.
If no preparer assisted with this affidavit, you may leave this page blank.
Preparer's Full Name
Preparer family name is required when preparer information is required.
Preparer given name is required when preparer information is required.
Preparer's Contact Information
Enter a valid daytime telephone number.
Enter a valid mobile telephone number, or leave it blank.
Enter a valid email address, or leave it blank.
Preparer's Certification and Signature
I certify, under penalty of perjury, that I prepared this affidavit for the sponsor at their request and with express consent and that all of the responses and information contained in and submitted with the affidavit are complete, true, and correct and reflect only information provided by the sponsor.
NOTE: Use your finger or mouse to draw your signature. Leave it blank if you prefer to sign the final PDF later.