Instructions For Request For Reduced Fee (Form I-942) (Page 2 of 7) in pdf

Translations. If you submit a document with information in a foreign language, you must also submit a full English

translation. The translator must sign a certification that the English language translation is complete and accurate, and that

he or she is competent to translate from the foreign language into English. The certification should also include the date,

the translator’s signature and printed name, and may contain the translator’s contact information.

How To Fill Out Form I-942

1. Type or print legibly in black ink.

2. If you need extra space to complete any item within this request, use the space provided in Part 8. Additional

Information or attach a separate sheet of paper; type or print your name and Alien Registration Number (A-Number)

(if any) at the top of each sheet; indicate the Page Number, Part Number, and Item Number to which your answer

refers.

3. Answer all questions fully and accurately. If a question does not apply to you (for example, if you have never been

married and the question asks, “Provide the name of your current spouse”), type or print “N/A,” unless otherwise

directed. If your answer to a question which requires a numeric response is zero or none (for example, “How many

children do you have” or “How many times have you departed the United States”), type or print “None,” unless

otherwise directed.

Specific Instructions

Part 1. Information About You (Requestor)

Item Number 1. Full Name. Provide your full name. If you have two last names, include both in the Family Name box

and use a hyphen (-) if appropriate. If you do not have a middle name, type or print “N/A.”

Item Number 2. Date of Birth (mm/dd/yyyy). Provide your date of birth in mm/dd/yyyy format. For example, enter

May 1, 1979, as 05/01/1979.

Item Number 3. Alien Registration Number (A-Number). An A-Number is a number assigned by USCIS or the

former Immigration and Naturalization Service (INS). People with A-Numbers can locate the number on their USCIS-

issued or INS-issued documentation.

Item Number 4. Marital Status. Indicate your current marital status.

Part 2. Information About Family Members Filing This Request With You

Item Number 1. Complete the table for yourself and each person requesting a reduced fee with you.

Part 3. Household Income

To qualify for the reduced fee, your household income must be greater than 150 percent and not more than 200 percent

of the Federal Poverty Guidelines, at the time of filing, based on your household size. The Federal Poverty Guidelines

are established by the Secretary of the Department of Health and Human Services annually. To obtain information on

the current Federal Poverty Guidelines, visit our website at

and review Form I-942P, Income

Guidelines for Reduced Fees.

Item Number 1. Employment Status. Indicate your current employment status. If you are both employed and a

student, select Other and provide an explanation.

Form I-942 Instructions 12/23/16

Page 2 of 7

Instructions For Request For Reduced Fee (Form I-942) Page 2