Here you go. I got this layout from another poster either on this board or one of the others I frequent, and modified it slightly for our circumstances. I don't know if you have to have this much, but I figured since I did, I may as well use it all, right?
I also wrote a little cover letter explaining why I was in the UK, and why we were moving back. Our initial plan was to live in the UK for up to 4 years, and then move, which is why I maintained everything, including my car. But a housing opportunity presented itself that really makes it hard to pass up going at this time.
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NAME
SOCIAL SECURITY NUMBER
FORM I-1864
No. 15 Country of Domicile
I, XXXX , am currently residing in England with my husband and his two children. Below you will find a list of attached documents to show that my principle residence is in the US and the steps that I have taken to return to the US with my family.
Steps I have taken to maintain US Domicile:
• Maintained my XXXX voter registration
• Maintained my XXXX credit card registered in the US with a US PO box
• Maintained my XXXX credit card registered in the US with a US PO box
• Maintained my bank account at the XXXX Credit Union
• Maintained my bank account at XXXX Bank
• Maintained my XXXX drivers license
• Maintained my US retirement fund through XXXX
• Maintained my US investment account with XXXX
• Maintained my US PO box
• Maintained licensure by the XXXX
• Maintained membership in the XXXX
• Maintained my automobile in care of my parents
Supporting Documents for the above steps I have taken:
• Voter registration card showing permanent US address
• XXXX credit card statement showing US billing address
• XXXX credit card statement showing US billing address
• XXXX Credit Union statement showing permanent US address
• XXXX Bank statement showing permanent US address
• XXXX drivers license showing permanent US address
• Retirement fund statement showing permanent US address
• Mutual fund statement showing permanent US address
• XXXX license currently up to date
• Renewal of XXXX membership
• County tax bill showing I still own a vehicle
Steps I have taken to return to the US to take up residence:
• Made arrangements for us to have a house to live in
• Contacted schools for requirements of things to bring to register my children in school
• Contacted my auto insurance company to find out about re-instating my insurance on my car
• Contacted shipping company for estimate of costs to ship belongings
Supporting documents for the above steps I have taken:
• Lease agreement for our house
• Email from schools regarding registration requirements
• Email from my former auto insurance company regarding my inquiry
• Email from XXXX with estimate and correspondence regarding shipping our belongings
I declare that I intend in good faith to re-establish my domicile in the United States no later than the date of my husband and children’s admission into the US.
I certify under penalty of perjury under the laws of the United States that the statements in this letter and all accompanying evidence are true and correct.
Signature: ____________________________________________________ Date: ______________________
NAME
