Instructions For Request For Reduced Fee (Form I-942) (Page 3 of 7) in pdf

Item Number 2. Information About Your Spouse. Indicate whether your spouse is living with you. If your spouse

lives with you, list your spouse in the table in Item Number 3. If applicable, indicate whether your spouse provides

any financial support to your household. If your spouse provides financial support to your household, include the

contributions that your spouse provides to your household in Item Number 6.

Item Number 3. Your Household Size. Indicate whether you are providing the primary financial support for your

household.

Complete the table with the information requested about the members of your household including their names, dates of

birth, relationship to you, whether the person is married, whether the person is a full-time student, and whether the person

earns income counted towards the household income.

For the last column (Is any income earned by this person counted towards the household income?), select yes if income is

received consistently or regularly as wages or salary from these household members’ employment or business.

At the end of the table, provide the total number of household members. Include the following people, who are dependent

on your income, your spouse’s income, or the head of household’s income, as part of your household size:

1. You;

2. The head of your household (if not you);

A. You are the head of household if you filed the most recent Federal tax return for your household (includes filing as

head of household) or earned the majority of the income for your household.

B. If you are not the head of household, the head of household is the person who filed the most recent Federal

tax return on which you are listed as a dependent or the person who provides the majority of your household’s

income.

3. Your spouse, if living with you (if you are separated or your spouse is not living with you, do not include your

spouse); or

4. Any family members living in your household who are dependent on your income, your spouse’s income, or the head

of household’s income, including:

A. Your children or legal wards who are unmarried and under 21 years of age, and who live with you;

B. Your children or legal wards who are unmarried, are over 21 years of age but under 24 years of age, are full-time

students, and who live with you when not at school;

C. Your children or legal wards who are unmarried and for whom you are the legal guardian because they are

physically or developmentally disabled or mentally impaired to the extent that they cannot adequately care for

themselves and cannot establish, maintain, or re-establish their own household;

D. Your parents who live with you; and

E. Any other dependents listed on your Federal tax return or your spouse or head of household’s Federal tax returns.

Item Number 4. Your Annual Income. Provide information on your annual income. If you filed a Federal tax return,

enter the amount from Line 37 (adjusted gross income) on Internal Revenue Service (IRS) Form 1040, U.S. Individual

Income Tax Return. If you have not filed a Federal tax return, take your total household wage income (before any

deductions) for the previous 12-month period and enter that amount as your household’s annual income. If you have

not filed a Federal income tax return but you have an IRS Form W-2, Wage and Tax Statement, that covers the previous

12-month period, take your total wage income, deduct Federal, state, and local income taxes withheld, and enter that

amount as your household’s annual wage income.

Documentation. To document your annual income, provide the following information:

1. A copy of your most recent Federal tax return;

Form I-942 Instructions 12/23/16

Page 3 of 7

Instructions For Request For Reduced Fee (Form I-942) Page 3