Fill in Your USCIS I-134 Template Get Document Here

Fill in Your USCIS I-134 Template

The USCIS I-134 form, also known as the Affidavit of Support, is a document used by individuals in the United States to demonstrate their financial ability to support a visa applicant. This form plays a crucial role in the immigration process, as it helps ensure that the applicant will not become a public charge. If you are ready to fill out the I-134 form, click the button below.

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Key takeaways

  • The I-134 form is used to demonstrate financial support for a visa applicant.
  • It is important to provide accurate and complete information to avoid delays in processing.
  • Include proof of income, such as recent pay stubs, tax returns, or bank statements.
  • The form must be signed by the sponsor, who agrees to support the applicant financially.
  • Make sure to include the sponsor's contact information for any follow-up questions.
  • It is advisable to provide details about the sponsor's household size and expenses.
  • Submitting the form does not guarantee visa approval, but it supports the application.
  • Keep a copy of the completed form for your records.
  • Review the form for any updates or changes in requirements before submission.

Dos and Don'ts

When filling out the USCIS I-134 form, it is essential to approach the process with care and attention to detail. This form is used to demonstrate financial support for a visa applicant. Here are ten important guidelines to consider:

  • Do read the instructions carefully before starting the form.
  • Do provide accurate and truthful information throughout the application.
  • Do include all required supporting documents to strengthen your application.
  • Do ensure your contact information is up-to-date and clearly written.
  • Do double-check your calculations if you are reporting income or assets.
  • Don't leave any sections blank; if a question does not apply, write "N/A."
  • Don't provide false information or exaggerate your financial situation.
  • Don't forget to sign and date the form before submission.
  • Don't submit the form without making copies for your records.
  • Don't rush through the process; take your time to ensure accuracy.

By adhering to these guidelines, you can help ensure that your I-134 form is completed correctly, which may facilitate a smoother application process for the visa applicant.

Form Overview

Fact Name Description
Purpose The I-134 form, also known as the Affidavit of Support, is used to demonstrate that an individual has adequate financial support when applying for a visa or green card.
Eligibility U.S. citizens and lawful permanent residents can complete the I-134 form to support a visa applicant. The sponsor must show they can financially support the applicant.
Submission The form must be submitted to the U.S. Citizenship and Immigration Services (USCIS) as part of the visa application process. It can be filed online or via mail.
Governing Law The I-134 form is governed by federal immigration law, specifically under the Immigration and Nationality Act (INA).

Common mistakes

  1. Inaccurate Personal Information: One common mistake is providing incorrect personal details. This can include misspellings of names, wrong dates of birth, or incorrect Social Security numbers. Double-checking this information is crucial, as errors can lead to delays or denials.

  2. Insufficient Financial Evidence: Applicants often fail to include adequate proof of financial support. It is important to provide recent tax returns, bank statements, and pay stubs. Without this documentation, the form may be considered incomplete.

  3. Missing Signatures: A simple yet significant error is neglecting to sign the form. Both the sponsor and the applicant must sign the I-134. Omitting a signature can result in the application being rejected.

  4. Not Updating Information: Some individuals forget to update their information if circumstances change. For example, if there is a change in employment status or financial situation, it is essential to reflect that on the form. Failure to do so can misrepresent the sponsor’s ability to support the applicant.

Similar forms

The USCIS I-134 form, also known as the Affidavit of Support, is similar to the I-864 form, which is another affidavit of support. Both forms are used to demonstrate that an individual has sufficient financial resources to support a foreign national. The key difference lies in their usage; the I-134 is often used for temporary visas, while the I-864 is required for permanent residency applications. Each form requires the sponsor to provide proof of income and assets, ensuring that the sponsored individual will not become a public charge.

Another document comparable to the I-134 is the I-130 form, which is a Petition for Alien Relative. While the I-134 focuses on financial support, the I-130 is used to establish a qualifying relationship between a U.S. citizen or permanent resident and a foreign national. Both forms are essential in the immigration process, but they serve different purposes. The I-130 lays the groundwork for family-based immigration, while the I-134 provides assurance of financial backing for the applicant.

For those involved in renting spaces, understanding legal documentation is crucial. The New York Room Rental Agreement is one such form that outlines the expectations and responsibilities of both landlords and tenants. This agreement not only ensures clarity in the rental relationship but also protects the rights of both parties. To explore the specifics of securing a rental space in New York, check out the NY PDF Forms for comprehensive resources.

The I-601 form, known as the Application for Waiver of Grounds of Inadmissibility, also shares similarities with the I-134. Both forms are part of the immigration process and require detailed personal information. However, the I-601 is specifically for individuals who are inadmissible to the U.S. and need a waiver to enter or adjust their status. While the I-134 assures financial support, the I-601 addresses legal barriers to immigration, highlighting the multifaceted nature of the immigration system.

Finally, the I-485 form, or Application to Register Permanent Residence or Adjust Status, is another document that relates to the I-134. The I-485 is used by individuals already in the U.S. who wish to become permanent residents. While the I-134 provides proof of financial support, the I-485 focuses on the applicant's eligibility for permanent residency. Both forms are integral to the adjustment of status process, ensuring that applicants meet financial and legal requirements for a successful transition to permanent residency.

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Your Questions, Answered

What is the purpose of the USCIS I-134 form?

The USCIS I-134 form, also known as the Affidavit of Support, is used to demonstrate that a visa applicant has sufficient financial support during their stay in the United States. This form is typically required for individuals seeking non-immigrant visas, such as tourist or student visas. By submitting this form, the sponsor agrees to provide financial assistance if the applicant is unable to support themselves, ensuring that the applicant will not become a public charge.

Who can be a sponsor on the I-134 form?

A sponsor must be a U.S. citizen or a lawful permanent resident. They should also have a stable income or sufficient assets to support the visa applicant. Generally, sponsors are family members or friends of the applicant, but they can also be employers or other individuals who are willing to take financial responsibility. It is important for the sponsor to provide accurate information about their income and assets to demonstrate their ability to support the applicant.

What information is required on the I-134 form?

The I-134 form requires several pieces of information from the sponsor, including:

  1. Name and address
  2. Relationship to the applicant
  3. Employment details, including job title and income
  4. Financial information, such as assets and liabilities
  5. Information about any dependents

Additionally, the sponsor must provide evidence of their financial capacity, which may include recent tax returns, pay stubs, or bank statements.

How does one submit the I-134 form?

The completed I-134 form should be submitted to the appropriate U.S. embassy or consulate where the visa applicant is applying. It is advisable to include supporting documents that verify the sponsor's financial situation. The submission process may vary depending on the specific embassy or consulate, so checking their website for detailed instructions is recommended.

What happens after the I-134 form is submitted?

Once the I-134 form is submitted, the U.S. embassy or consulate will review the application along with the supporting documents. They will assess whether the sponsor has sufficient financial means to support the applicant. If approved, the applicant may proceed with their visa application process. However, if the form is deemed insufficient, additional documentation may be requested, or the application could be denied. It is crucial for the sponsor to ensure that all information is accurate and complete to avoid delays or issues.

Form Preview

 

Affidavit of Support

USCIS

 

Department of Homeland Security

Form I-134

 

OMB No. 1615-0014

 

U.S. Citizenship and Immigration Services

Expires 02/28/2021

 

 

 

 

 

 

 

 

 

 

 

 

START HERE - Type or print in black ink.

Part 1. Information About You (the Sponsor)

Your Full Name

1.a. Family Name

(Last Name)

1.b. Given Name

(First Name)

1.c. Middle Name

Other Names Used

List all other names you have ever used, including aliases, maiden name, and nicknames. If you need extra space to complete this section, use the space provided in Part 7.

Additional Information.

2.a. Family Name

(Last Name)

2.b. Given Name

(First Name)

2.c. Middle Name

Sponsor's Mailing Address

(USPS ZIP Code Lookup)

 

 

3.a. In Care Of Name

3.b. Street Number

and Name

3.c. Apt. Ste. Flr.

3.d. City or Town

3.e. State

 

3.f. ZIP Code

 

 

 

3.g. Province

3.h. Postal Code

3.i. Country

4.Are your mailing address and physical address the same?

Yes No

If you answered "No" to Item Number 4., provide your physical address in Item Numbers 5.a. - 5.h.

Sponsor's Physical Address

5.a. Street Number

and Name

5.b. Apt. Ste. Flr.

5.c. City or Town

5.d. State

 

5.e. ZIP Code

 

 

 

5.f. Province

5.g. Postal Code

5.h. Country

Other Information

6.Date of Birth (mm/dd/yyyy)

7.a. Town or City of Birth

7.b. Country of Birth

8.Alien Registration Number (A-Number) (if any)

A-

9.U.S. Social Security Number (if any)

10.USCIS Online Account Number (if any)

Citizenship or Residency or Status

If you are not a U.S. citizen based on your birth in the United States, or a non-citizen U.S. national based on your birth in American Samoa (including Swains Island), answer the following as appropriate:

11.a. I am a U.S. citizen through naturalization. My Certificate of Naturalization number is

11.b. I am a U.S. citizen through parent(s) or marriage. My Certificate of Citizenship number is

Form I-134 02/13/19

Page 1 of 8

Part 1. Information About You (the Sponsor)

(continued)

11.c.

 

I derived my U.S. citizenship by another method.

 

 

(Provide an explain in Part 7. Additional

 

 

Information.)

11.d.

 

I am a lawful permanent resident of the

 

 

United States. My A-Number is

 

 

A-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11.e.

 

I am a lawfully admitted nonimmigrant. My

 

 

Form I-94, Arrival-Departure Record Number is

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12.

I am

 

 

 

years of age and have resided in the United

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

States since (Date) (mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part 2. Information About the Beneficiary

This affidavit is executed on behalf of the following person:

1.a. Family Name

(Last Name)

1.b. Given Name

(First Name)

1.c. Middle Name

2.Date of Birth (mm/dd/yyyy)

3. Gender Male Female

4.A-Number (if any)

A-

5.Country of Citizenship or Nationality

6.Marital Status

Single or Single, Never Married

Married

Divorced

Widowed

Legally Separated

Marriage Annulled

Other

7.Relationship to Sponsor

Beneficiary's Physical Address

8.a.

Street Number

 

 

 

 

 

and Name

 

 

 

 

 

 

 

Apt.

 

 

 

 

 

 

8.b.

Ste.

Flr.

 

 

8.c.

City or Town

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8.d.

State

 

 

 

8.e.

ZIP Code

 

 

 

 

 

 

 

 

 

 

8.f.

Province

 

 

 

 

 

 

 

 

 

 

 

 

8.g.

Postal Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8.h.

Country

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Beneficiary's Spouse (accompanying or following to join beneficiary)

9.a. Family Name

(Last Name)

9.b. Given Name

(First Name)

9.c. Middle Name

10.Date of Birth (mm/dd/yyyy)

11.Gender Male Female

Beneficiary's Children

Child 1

12.a. Family Name

(Last Name)

12.b. Given Name

(First Name)

12.c. Middle Name

13.Date of Birth (mm/dd/yyyy)

14.Gender Male Female

Child 2

15.a. Family Name

(Last Name)

15.b. Given Name

(First Name)

15.c. Middle Name

16.Date of Birth (mm/dd/yyyy)

17. Gender Male Female

If you need additional space to complete this section, use the

space provided in Part 7. Additional Information.

Form I-134 02/13/19

Page 2 of 8

Part 3. Other Information About the Sponsor

7.a. I have life insurance in the sum of $

Employment Information

I am currently:

1.a. Employed as a/an

1.a.1. Name of Employer (if applicable)

1.b.

Self employed as a/an

 

 

 

 

Current Employer Address (if employed)

2.a. Street Number

and Name

2.b. Apt. Ste. Flr.

2.c. City or Town

2.d. State

 

2.e. ZIP Code

 

 

 

2.f. Province

2.g. Postal Code

2.h. Country

Income and Asset Information

3. My annual income is

$

(If self-employed, I have attached a copy of my last income tax return or report of commercial rating concern which I certify to be true and correct to the best of my knowledge and belief. See Instructions for nature of evidence of net worth to be submitted.)

4.Balance of all my savings and checking accounts in United States-based financial institutions

$

5.Value of my other personal property

$

6.Market value of my stocks and bonds

$

I have listed my stocks and bonds in Part 7. Additional Information (or attached a list of them), which I certify to be true and correct to the best of my knowledge and belief.

7.b. With a cash surrender value of

$

Real Estate Information

8.a. I own real estate valued at

$

8.b. I have mortgages or other debts amounting to

$

My real estate is located at:

9.a. Street Number

and Name

9.b. Apt. Ste. Flr.

9.c. City or Town

9.d. State

 

9.e. ZIP Code

 

 

 

Dependents' Information

The following persons are dependent upon me for support. If you need extra space to complete this section, use the space provided in Part 7. Additional Information.

10.a. Family Name

(Last Name)

10.b. Given Name

(First Name)

10.c. Middle Name

11.Relationship to Me:

12.Date of Birth (mm/dd/yyyy)

13.This person is:

Wholly Dependent On Me For Support

Partially Dependent On Me For Support

14.a. Family Name

(Last Name)

14.b. Given Name

(First Name)

14.c. Middle Name

15.Relationship to Me:

16.Date of Birth (mm/dd/yyyy)

Form I-134 02/13/19

Page 3 of 8

Part 3. Other Information About the Sponsor

(continued)

17.This person is:

Wholly Dependent On Me For Support

Partially Dependent On Me For Support

18.a. Family Name

(Last Name)

18.b. Given Name

(First Name)

18.c. Middle Name

19.Relationship to Me:

20.Date of Birth (mm/dd/yyyy)

21.This person is:

Wholly Dependent On Me For Support

Partially Dependent On Me For Support

I have previously submitted affidavit(s) of support for the following person(s). (If none, write "None" in the space for name below.)

22.a. Family Name

(Last Name)

22.b. Given Name

(First Name)

22.c. Middle Name

23.Date Submitted (mm/dd/yyyy)

24.a. Family Name

(Last Name)

24.b. Given Name

(First Name)

24.c. Middle Name

25.Date Submitted (mm/dd/yyyy)

I have submitted a visa petition(s) to U.S. Citizenship and Immigration Services on behalf of the following persons. (If none, write “None” in the space for name below.)

26.a. Family Name

(Last Name)

26.b. Given Name

(First Name)

26.c. Middle Name

27.Relationship to Me:

28. Date of Birth (mm/dd/yyyy)

29. Date of Filing (mm/dd/yyyy)

30.a. Family Name

(Last Name)

30.b. Given Name

(First Name)

30.c. Middle Name

31.Relationship to Me:

32. Date of Birth (mm/dd/yyyy)

33. Date of Filing (mm/dd/yyyy)

34.a. Family Name

(Last Name)

34.b. Given Name

(First Name)

34.c. Middle Name

35.Relationship to Me:

36. Date of Birth (mm/dd/yyyy)

37. Date of Filing (mm/dd/yyyy)

38.I intend do not intend to make specific contributions to the support of the person(s) named in Part 2.

(If you select "intend," indicate the exact nature and duration of the contributions you intend to make in Part 7. Additional Information. For example, if you intend to furnish room and board, state for how long and, if money, state the amount in U.S. dollars and whether it is to be given in a lump sum, weekly or monthly, and for how long.)

Form I-134 02/13/19

Page 4 of 8

Part 4. Sponsor's Statement, Contact Information, Certification, and Signature

NOTE: Read the Penalties section of the Form I-134 Instructions before completing this part.

Sponsor's Statement

NOTE: Select the box for either Item Number 1.a. or 1.b. If applicable, select the box for Item Number 2.

1.a.

I can read and understand English, and I have read and

 

understand every question and instruction on this

 

affidavit and my answer to every question.

1.b.

The interpreter named in Part 5. read to me every

 

question and instruction on this affidavit and my

 

answer to every question in

 

 

,

 

 

 

 

a language in which I am fluent and I understood

 

everything.

2.

At my request, the preparer named in Part 6.,

 

 

 

 

,

 

 

 

prepared this affidavit for me based only upon information I provided or authorized.

Sponsor's Contact Information

3.Sponsor's Daytime Telephone Number

4.Sponsor's Mobile Telephone Number (if any)

5.Sponsor's Email Address (if any)

Sponsor's Certification

Copies of any documents I have submitted are exact photocopies of unaltered, original documents, and I understand that USCIS or the Department of State may require that I submit original documents to USCIS or the Department of State at a later date. Furthermore, I authorize the release of any information from any of my records that USCIS or the Department of State may need to determine my eligibility for the immigration benefit I seek.

I further authorize release of information contained in this affidavit, in supporting documents, and in my USCIS or the Department of State records to other entities and persons where necessary for the administration and enforcement of U.S. immigration laws.

I understand that USCIS may require me to appear for an appointment to take my biometrics (fingerprints, photograph, and/or signature) and, at that time, if I am required to provide biometrics, I will be required to sign an oath reaffirming that:

1)I reviewed and provided or authorized all of the information in my affidavit;

2)I understood all of the information contained in, and submitted with, my affidavit; and

3)All of this information was complete, true, and correct at the time of filing.

I certify, under penalty of perjury, that I provided or authorized all of the information in my affidavit, I understand all of the information contained in, and submitted with, my affidavit, and that all of this information is complete, true, and correct.

That this affidavit is made by me to assure the U.S. Government that the person named in Part 2. will not become a public charge in the United States.

That I am willing and able to receive, maintain, and support the person named in Part 2. I am ready and willing to deposit a bond, if necessary, to guarantee that such persons will not become a public charge during his or her stay in the United States, or to guarantee that the above named persons will maintain his or her nonimmigrant status, if admitted temporarily, and will depart prior to the expiration of his or her authorized stay in the United States.

That I understand that Form I-134 is an "undertaking" under section 213 of the Immigration and Nationality Act, and I may be sued if the persons named in Part 2. become a public charge after admission to the United States.

That I understand that Form I-134 may be made available to any Federal, State, or local agency that may receive an application from the persons named in Part 2. for Food Stamps, Supplemental Security Income, or Temporary Assistance to Needy Families.

That I understand that if the person named in Part 2. does apply for Food Stamps, Supplemental Security Income, or Temporary Assistance for Needy Families, my own income and assets may be considered in deciding the person's application. How long my income and assets may be attributed to the persons named in Part 2. is determined under the statutes and rules governing each specific program.

I acknowledge that I have read the section entitled Sponsor and Beneficiary Liability in the Instructions for this affidavit, and am aware of my responsibilities as a sponsor under the Social Security Act, as amended, and the Food Stamp Act, as amended.

Sponsor's Signature

6.a. Sponsor's Signature

6.b. Date of Signature (mm/dd/yyyy)

Form I-134 02/13/19

Page 5 of 8

NOTE TO ALL SPONSORS: If you do not completely fill out this affidavit or fail to submit required documents listed in the Instructions, USCIS or the Department of State may deny your affidavit.

Part 5. Interpreter's Contact Information, Certification, and Signature

Provide the following information about the interpreter.

Interpreter's Full Name

1.a. Interpreter's Family Name (Last Name)

1.b. Interpreter's Given Name (First Name)

2.Interpreter's Business or Organization Name (if any)

Interpreter's Mailing Address

3.a. Street Number

and Name

3.b. Apt. Ste. Flr.

3.c. City or Town

3.d. State

 

3.e. ZIP Code

 

 

 

3.f. Province

3.g. Postal Code

3.h. Country

Interpreter's Certification

I certify, under penalty of perjury, that:

 

I am fluent in English and

,

which is the same language provided in Part 4., Item Number 1.b., and I have read to this sponsor in the identified language every question and instruction on this affidavit and his or her answer to every question. The sponsor informed me that he or she understands every instruction, question, and answer on the affidavit, including the Sponsor's Certification, and has verified the accuracy of every answer.

Interpreter's Signature

7.a. Interpreter's Signature

7.b. Date of Signature (mm/dd/yyyy)

Part 6. Contact Information, Statement, Declaration, and Signature of the Person Preparing this Affidavit, if Other Than the Sponsor

Provide the following information about the preparer.

Preparer's Full Name

1.a. Preparer's Family Name (Last Name)

1.b. Preparer's Given Name (First Name)

2.Preparer's Business or Organization Name (if any)

Interpreter's Contact Information

4.Interpreter's Daytime Telephone Number

5.Interpreter's Mobile Telephone Number (if any)

6.Interpreter's Email Address (if any)

Preparer's Mailing Address

3.a. Street Number

and Name

3.b. Apt. Ste. Flr.

3.c. City or Town

3.d. State

 

3.e. ZIP Code

 

 

 

3.f. Province

3.g. Postal Code

3.h. Country

Form I-134 02/13/19

Page 6 of 8

Part 6. Contact Information, Statement, Declaration, and Signature of the Person Preparing this Affidavit, if Other Than the

Sponsor (continued)

Preparer's Contact Information

4.Preparer's Daytime Telephone Number

5.Preparer's Fax Number

6.Preparer's Email Address (if any)

Preparer's Statement

7.a.

I am not an attorney or accredited representative but have prepared this affidavit on behalf of the sponsor and with the sponsor's consent.

7.b. I am an attorney or accredited representative and my representation of the sponsor in this case

extends does not extend beyond the preparation of this affidavit.

NOTE: If you are an attorney or accredited representative whose representation extends beyond preparation of this affidavit, you may be obliged to submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited Representative, with this application.

Preparer's Certification

By my signature, I certify, under penalty of perjury, that I prepared this affidavit at the request of the sponsor. The sponsor then reviewed this completed affidavit and informed me that he or she understands all of the information contained in, and submitted with, his or her affidavit, including the Sponsor's Certification, and that all of this information is complete, true, and correct. I completed this affidavit based only on information that the sponsor provided to me or authorized me to obtain or use.

Preparer's Signature

8.a. Preparer's Signature

8.b. Date of Signature (mm/dd/yyyy)

Form I-134 02/13/19

Page 7 of 8

Part 7. Additional Information

If you need extra space to provide any additional information within this affidavit, use the space below. If you need more space than what is provided, you may make copies of this page to complete and file with this affidavit or attach a separate sheet of paper. Type or print your name and A-Number (if any) at the top of each sheet; type or print the Page Number, Part Number, and Item Number to which your answer refers; and sign and date each sheet.

5.a. Page Number 5.b. Part Number 5.c. Item Number

5.d.

Your Full Name

1.a.

Family Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Last Name)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.b.

Given Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(First Name)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.c.

Middle Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

A-Number (if any)

 

 

 

 

 

 

 

6.a. Page Number 6.b. Part Number 6.c. Item Number

 

 

 

A-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.a.

Page Number 3.b. Part Number

3.c. Item Number

6.d.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.d.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7.a. Page Number 7.b. Part Number 7.c. Item Number

 

 

 

 

 

 

 

 

 

 

 

 

4.a. Page Number 4.b. Part Number

4.c. Item Number

7.d.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.d.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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