Form I-912p - Hhs Poverty Guidelines For Fee Waiver Request - 2017

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2017 HHS Poverty Guidelines for Fee Waiver Request
USCIS
Form I-912P
Department of Homeland Security
Supplement
U.S. Citizenship and Immigration Services
2017 HHS Poverty Guidelines*
For the 48 Contiguous States, the District of Columbia, Puerto Rico, the U.S. Virgin Islands,
Guam, and the Commonwealth of the Northern Mariana Islands:
Household Size
150% of HHS Poverty Guidelines*
$18,090
1
$24,360
2
$30,630
3
$36,900
4
5
$43,170
$49,440
6
$55,710
7
$61,980
8
Add $6,270 for each
additional person.
For Alaska:
For Hawaii:
Household Size
150% of HHS Poverty Guidelines*
Household Size
150% of HHS Poverty Guidelines*
$22,590
1
$20,790
1
2
$30,435
2
$28,005
$38,280
3
$35,220
3
$46,125
4
$42,435
4
$53,970
5
$49,650
5
$61,815
6
$56,865
6
$69,660
7
$64,080
7
$77,505
8
$71,295
8
Add $7,845 for each
Add $7,215 for each
additional person.
additional person.
* These poverty guidelines remain in effect for use with Form I-912, Request for Fee Waiver, from January 26, 2017 until new
guidelines go into effect in 2018.
Form I-912P 02/06/17 N
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