Form I-864 - Affidavit Of Support Under Section 213a Of The Act Page 14
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16OMB# 1115-0214
U. S. Department of Homeland Security
Poverty Guidelines
Bureau of Citizenship and Immigration Services
2003 Poverty Guidelines*
Minimum Income Requirement For Use in Completing Form I-864
For the 48 Contiguous States, the District of Columbia, Puerto Rico,
the U.S. Virgin Islands, and Guam:
Sponsor's
125% of Poverty Line
100% of Poverty Line
Household Size
For all other sponsors
For sponsors on active duty
in the U.S. Armed Forces who
are petitioning for their spouse
or child.
$15,150
$12,120
2
19,075
3
15,260
23,000
4
18,400
26,925
5
21,540
6
30,850
24,680
34,775
7
27,820
38,700
8
30,960
Add $3,140 for each
Add $3,925 for each
additional person.
additional person.
For Hawaii
For Alaska
Sponsor's
125% of Poverty Line
100% of Poverty Line
125% of Poverty Line
100% of Poverty Line
Household Size
For all other sponsors
For sponsors on active duty
For all other sponsors
For sponsors on active duty
in the U.S. Armed Forces
in the U.S. Armed Forces
who are petitioning for
who are petitioning for
their spouse or child
their spouse or child
$18,925
$13,940
$17,425
2
$15,140
3
17,550
21,937
23,837
19,070
21,160
4
23,000
28,750
26,450
24,770
5
33,662
30,962
26,930
38,575
35,475
6
28,380
30,860
39,987
7
43,487
31,990
34,790
48,400
44,500
35,600
8
38,720
Add $4,912 for each
Add $4,512 for each
Add $3,930 for each
Add $3,610 for each
additional person.
additional person.
additional person.
additional person.
Means-tested Public Benefits
Federal Means-tested Public Benefits. To date, Federal agencies administering benefit programs have determined
that Federal means-tested public benefits include Food Stamps, Medicaid, Supplemental Security Income (SSI),
Temporary Assistance for Needy Families (TANF), and the State Child Health Insurance Program (SCHIP).
State Means-tested Public Benefits. Each State will determine which, if any, of its public benefits are
means-tested. If a State determines that it has programs which meet this definition, it is encouraged to provide notice to
the public on which programs are included. Check with the State public assistance office to determine which, if any,
State assistance programs have been determined to be State means-tested public benefits.
Programs Not Included: The following Federal and State programs are not included as means-tested benefits:
emergency Medicaid; short-term, non-cash emergency relief; services provided under the National School Lunch
and Child Nutrition Acts; immunizations and testing and treatment for communicable diseases; student assistance
under the Higher Education Act and the Public Health Service Act; certain forms of foster-care or adoption
assistance under the Social Security Act; Head Start Programs; means-tested programs under the Elementary and
Secondary Education Act; and Job Training Partnership Act programs.
* These poverty guidelines remain in effect for use with the Form I-864 Affidavit of Support from April 1, 2003 until new poverty
guidelines go into effect in the Spring of 2004.
Form I-864P (Rev. 03/10/03)N
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