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Reason for exemption. I am EXEMPT from filing a Form I-864 Affidavit of Support because I have earned or can be credited with 40 quarters credits of coverage under the Social Security Act SSA. OMB No* 1615-0075 Expires 03/31/2015 I-864W Intending Immigrant s Affidavit of Support Exemption Department of Homeland Security U*S* Citizenship and Immigration Services Part 1. Information about the intending immigrant. You or your adopted child. Last Name 1. Name For Government Use Only First Name 2. A ...

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