Table of Changes

TABLE OF CHANGES – INSTRUCTIONS

FORM I-912, Request for Fee Waiver

Revised July 22 2011

RIN: OMB No. 1615-0116

LOCATION	CURRENT VERSION	PROPOSED VERSION
Page 1 Introduction	U.S. Citizenship and Immigration Services (USCIS) is funded largely by application and petition fees. Waiving a fee transfers the cost of processing applications and petitions to others through higher fees. However, we recognize that some individuals may not be able to pay the filing fee. If you want USCIS to consider waiving the fee for your application, or petition, follow the instructions below to complete Form I-912, Request for Fee Waiver. When you request a fee waiver, you must clearly demonstrate that you are unable to pay the fee. USCIS officers will evaluate all factors, circumstances, and evidence supplied in support of a fee waiver request when making a final determination. Each case is unique and will be considered on its own merits.	U.S. Citizenship and Immigration Services (USCIS) is funded largely by application, petition, and biometrics services fees. Waiving a fee transfers the cost of processing applications and petitions to others through higher fees. However, we recognize that some individuals may not be able to pay the fees. If you want USCIS to consider waiving the fee for your application, petition, or biometrics services, follow the instructions below to complete Form I-912, Request for Fee Waiver. When you request a fee waiver, you must clearly demonstrate that you are unable to pay the fee. USCIS officers will evaluate all factors, circumstances, and evidence supplied in support of a fee waiver request when making a final determination. Each case is unique and will be considered on its own merits.
Page 1 Column 1, C.	C. Form I-192, Application for Advance Permission to Enter as Nonimmigrant (Under Section 212(d)(3)(A)(ii) of the Immigration and Nationality Act (INA)). The fee for Form I-192 can only be waived for an alien who is not subject to a determination of their likelihood of becoming a public charge under section 212(a)(4) of the INA;	C. Form I-192, Application for Advance Permission to Enter as Nonimmigrant (Under Section 212(d)(3)(A)(ii) of the Immigration and Nationality Act (INA)). The fee for Form I-192 can only be waived for an alien who is not subject to a determination of his or her likelihood of becoming a public charge under section 212(a)(4) of the INA; and for individuals with any benefit request as specified by section 245(l)(7) of the INA;
Page 1 Column 2, E. 1.	1. "T" nonimmigrant status (victim of human trafficking) or "U" nonimmigrant status (victim of certain crimes who has assisted in prosecution);	1. "T" nonimmigrant status (victim of human trafficking) or "U" nonimmigrant status (victim of certain crimes who has assisted in an investigation or prosecution);
Page 1 Column 2, E. 3.	Approved status as a battered or abused spouse, child, or parent of a U.S. citizen or lawful permanent resident, or for a special immigrant juvenile;	Approved status as a battered or abused spouse, child, or parent of a U.S. citizen or lawful permanent resident;
Page 1 Column 2, G. 2nd sentence	The fee for Form I-601 can only be waived for an alien who is not subject to a determination of their likelihood of becoming a public charge under section 212(a)(4) of the INA;	The fee for Form I-601 can only be waived for an alien who is not subject to a determination of his or her likelihood of becoming a public charge under section 212(a)(4) of the INA; and for individuals with any benefit request as specified by section 245(l)(7) of the INA;
Page 2 Column 1, 1st sentence below T.	Some applications and petitions do not require a fee at all and do not require you to submit a Form I-912.	Some applications and petitions do not require a fee at all, and so it is unnecessary to file a Form I-912.
Page 2, Fee Waiver Request Review Process.	1. How will USCIS determine if you qualify for a fee waiver? USCIS will review your Form I-912 according to the process described below. Additional details, including evidence, need to be followed as explained in each step…..	1. How will USCIS determine if I qualify for a fee waiver? USCIS will review your Form I-912 according to the process described below. Additional details, including evidence, need to be provided as explained in each step below:
Page 2., Step 1, B.	Examples of means-tested benefit programs are Medicaid, Food Stamps…..Temporary Assistance to Needy Families (TANF), Supplemental Security Income (SSI), among others.	Examples of means-tested benefit programs are Medicaid, Food Stamps…..Temporary Assistance to Needy Families (TANF), and Supplemental Security Income (SSI), among others.
Page 3 Column 1	STEP 2 4. How will you use my household income information to determine my eligibility for a fee waiver? A. We will compare your household income with the Federal Poverty Guidelines in effect at the time of filing as established by the Secretary of Health and Human Services. These guidelines change every year. To view the most current Federal Poverty Guidelines, go to http://aspe.hhs.gov/poverty. You can also call toll-free 1-866-758-1060 to obtain information on the current Federal Poverty Guidelines. B. If your household income is at or below 150% of the Federal Poverty Guidelines, you will qualify for a fee waiver. If your household income is over 150% of the Federal Poverty Guidelines, and if you have a financial hardship that would impact your ability to pay, such as large medical bills or other unexpected expenses, please see Step 3.	STEP 2 4. How will you use my household income information to determine my eligibility for a fee waiver? A. We will compare your household income with the Federal Poverty Guidelines in effect at the time of filing as established by the Secretary of Health and Human Services. These guidelines change every year. To obtain information on the current Federal Poverty Guidelines, visit our Web site at www.uscis.gov, select “Forms” and review Form I-912P, Poverty Guidelines for Fee Waiver Request. B. If your household income is at or below 150% of the Federal Poverty Guidelines, you will qualify for a fee waiver. If your household income is over 150% of the Federal Poverty Guidelines, and if you have a financial hardship that would impact your ability to pay, such as large medical bills or other unexpected expenses, please see Step 3.
Page 3 Column 2	6. Who should I include when determining my household size?	6. Whom should I include when determining my household size?
Page 4, Column 2, 13	B. Information concerning your liabilities and expenses. Liabilities and expenses for this purpose include: the cost of rent, mortgages, leases, the average monthly cost for food….and monthly payments on any lawful debts.	B. Information concerning your liabilities and expenses. Liabilities and expenses for this purpose include: the cost of rent, mortgages, leases, the average monthly cost for food…monthly payments on any lawful debts, and any other unexpected expenses.
Page 4 Column 1, 8	8. If I am separated, do I need to count my spouse in my household size and include their income as part of household income?	8. If I am separated, do I need to count my spouse in my household size and include their income as part of my household income?
Page 4 Column 2, 14		For additional information on the Federal Poverty Guidelines, see Form I-912P.
Page 5, 4.	If I am filing more than one application at the same time, do I need to include a fee waiver request for each application and petition? No. You can file one fee waiver request covering all applications and biometric fees filed for that applicant in the same envelope.	If I am filing more than one application or petition at the same time, do I need to include a fee waiver request for each application and/or petition? No. You can file one fee waiver request covering all applications, petitions, and biometrics services fees filed for that applicant in the same envelope.
Page 5.	5. All phrases that read “biometric services fee” or “biometric services fees”	5. Revised to read “biometrics services fee” or “biometrics services fees”
Page 5.	6. Will requesting a fee waiver affect my current immigration status? B. The fee waiver determination, however, is made separately from the adjudication of your eligibility of the USCIS benefit.	6. Will requesting a fee waiver affect my current immigration status? B. The fee waiver determination, however, is made separately from the adjudication of your eligibility for the USCIS benefit.
Page 5, General Instructions for Completing Form I-912	B. We recommend that you use the Adobe-fillable form available on the USCIS Web site. If not available, type or print in black ink.	B. We recommend that you use the Adobe-fillable form available on the USCIS Web site. If the Adobe-fillable form is not available, type or print your answers in black ink.
Page 6, Section 2, Line 7	Provide requested information for each dependent who is part of this request. This can include spouse, children, and wards.	Provide the requested information for each dependent who is part of this request. This can include your spouse, children, and wards.
Page 6 Section 3 – Basis for your request	This choice relates to you, the person named in Section 1. Line 8. a. If you are currently receiving a means-tested benefit, check "a." and attach documentation. Please complete Sections 4 and 7 of the form. Line 8. b. If your household income is at or below 150% of the Federal Poverty Guidelines, check "b." and attach documentation. Please complete Sections 5 and 7 of the form. Line 8. c. If you have a financial hardship, check "c." and attach documentation. Please complete Sections 5, 6, and 7 of the form.	This choice relates to you, the person named in Section 1. Line 8. a. If you or a relevant member of your household is currently receiving a means-tested benefit, check "8.a." and attach documentation. Please complete Sections 4 and 7 of the form. See Step 1, Question 3 (Page 3 of these instructions) to determine if you can include information on other members of your household who may be receiving a means-tested benefit. Line 8. b. If your household income is at or below 150% of the Federal Poverty Guidelines, check "8.b." and attach documentation. Please complete Sections 5 and 7 of the form. Line 8. c. If you have a financial hardship, check "8.c." and attach documentation. Please complete Sections 5, 6, and 7 of the form.
Page 6 Section 4 – Means-Tested Benefit	Line 9. In the space provided, enter the name of the person receiving the benefit, the name of the agency awarding the benefit, the date the benefit was awarded, and whether the recipient is currently receiving the benefit. If you are receiving a means-tested benefit and have evidence to support your claim, you may go directly to Section 7.	Line 9. In the space provided, enter the name of the person receiving the benefit, the name of the agency awarding the benefit, the date the benefit was awarded, and whether the recipient is currently receiving the benefit. If you listed a means-tested benefit and have evidence to support your claim, you may go directly to Section 7.
Page 6, Section 6- FINANCIAL HARDSHIP	Line 17. In the space provided, enter your average monthly costs for the categories provided. If you need additional space, attach a separate sheet of paper.	Line 17. In the space provided, enter your average monthly costs for the categories provided. Provide evidence of monthly payments where possible. If you need additional space, attach a separate sheet of paper.
Page 6, Section 7- YOUR SIGNATURE AND AUTHORIZATION	Line 18. After you read the release…including the release of your Federal tax return, that USCIS needs to determine your eligibility.	Line 18. After you read the release…including the release of your Federal tax returns, that USCIS needs to determine your eligibility.
Page 7, Filing Your Request, 2d para	Your completed USCIS application(s) or petition(s), Form I-912…..mailed to the USCIS office according to the “Where To File” directions identified in the application or petition form instructions…….	Your completed USCIS application(s) or petition(s), Form I-912…..mailed to the USCIS office according to the “Where To File” directions in the application or petition form instructions…….
Page 7 Additional Information		IMPORTANT NOTE: If USCIS denies your fee waiver request, please pay close attention to the information on resubmitting your application or petition that will be in the USCIS notice denying your fee waiver request. For certain immigration benefits, you may have only a limited period of time in which to resubmit your application or petition with the proper fee.
Page 7 Privacy Act Notice	We ask for the information on Form I-912, and associated evidence, to determine if you have established eligibility for the immigration benefit for which you are filing. Our legal right to ask for this information can be found in the Immigration and Nationality Act, as amended. We may provide this information to other government agencies. Failure to provide this information, and any requested evidence, may delay a final decision or result in denial of your Form I-912. Immigration laws are often complex. We try to create forms and instructions that are easy to understand and that impose the least possible burden in terms of information and evidence required. For Form I-912, we estimate that on average it will take a customer 1 hour and 10 minutes to learn about the law, the form, our process, download the form from our Web site, and complete and submit the request. If you have any comments about this estimate, or suggestions for making the form simpler, contact: U.S. Citizenship and Immigration Services, Regulatory Products Division, Office of the Executive Secretariat, 20 Massachusetts Avenue N.W., Washington, DC 20529-2020. You can also write to the Office of Management and Budget, Paperwork Reduction Project, OMB No. 1615-0116, Washington, DC 20503. (Do not mail your Form I-912 to either of these addresses.)	USCIS Privacy Act Statement AUTHORITIES: The information requested on this form, and the associated evidence, is collected pursuant to The Immigration and Nationality Act (INA), as amended, INA section 101,et seq. PURPOSE: The primary purpose for providing the requested information on this form is to determine if a fee waiver request should be approved. DISCLOSURE: The information you provide is voluntary. However, failure to provide the requested information, and any requested evidence, may delay a final decision or result in denial of your fee waiver request. ROUTINE USES: The information you provide on this form may be shared with other federal, state, local, and foreign government agencies and authorized organizations in accordance with approved routine uses, as described in the associated published system of records notices [DHS-USCIS-007 - Benefits Information System and DHS-USCIS-001 - Alien File (A-File) and Central Index System (CIS), which can be found at www.dhs.gov/privacy]. The information may also be made available, as appropriate for law enforcement purposes or in the interest of national security.
Page 7 Paperwork Reduction Act		An agency may not conduct or sponsor an information collection, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The public reporting burden for this collection of information is estimated at 1 hour and 10 minutes per response, including the time for reviewing instructions and completing and submitting the form. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: U.S. Citizenship and Immigration Services, Regulatory Products Division, Office of the Executive Secretariat, 20 Massachusetts Avenue, N.W., Washington, DC 20529-2020; OMB No 1615-0116. This form expires October 31, 2012. Do not mail your Form I-912 to this address.

TABLE OF CHANGES – FORM

FORM I-912, Request for Fee Waiver

Revised July 22, 2011

RIN: OMB No. 1615-0116

LOCATION	CURRENT VERSION	PROPOSED VERSION
Page 1 For USCIS Use Only	For USCIS Use Only [ ] Approved Signature of Approving Officer [ ] [ ] Denied Officer’s Comments [ ]	FOR USCIS USE ONLY Application Receipted At (check only one box): USCIS Field Office [ ] Fee Waiver Approved Date: _______________ [ ] Fee Waiver Denied Date: _______________ USCIS Service Center [ ] Fee Waiver Approved Date: _______________ [ ] Fee Waiver Denied Date: _______________
Page 1, Section 1, Line 6	Biometric services fees, where applicable, will be included in the request.	Biometrics services fees, where applicable, will be included in the fee waiver request.
Page 1 Section 2	Line 7. Complete the Table below if applicable. (If you need more space, attach a separate sheet of paper)	Line 7. Complete the Table below if applicable. (If you need more space, attach a separate sheet of paper.)
Page 2 Section 3 – Header	Section 3. Basis for Your Request (Check any that apply)	Section 3. Basis for Your Request (Check any that apply. For additional information, see the Form Instructions.)
Page 2 Section 3	Line 8.a. a. I am receiving a means-tested benefit. (complete Section 4)	Line 8.a. a. I am or a relevant member of my household is currently receiving a means-tested benefit. (complete Sections 4 and 7)
	Line 8.b. b. My household income is at or below 150% of the Federal Poverty Guidelines. (complete Section 5)	Line 8.b. b. My household income is at or below 150% of the Federal Poverty Guidelines. (complete Sections 5 and 7)
	Line 8.c. c. I have a financial hardship. (complete Section 6)	Line 8.c. c. I have a financial hardship. (complete Sections 5, 6 and 7)
Page 2 Section 4	Line 9. Complete the Table Below (If you need more space, attach a separate sheet of paper)	Line 9. Complete the Table Below (If you need more space, attach a separate sheet of paper.)
Page 2 Section 4 Table	Are You Receiving This Benefit Now?	Is This Benefit Being Received Now? (Please add 4 additional rows to the chart to correspond with the number of persons (in addition to the applicant) in Section 2.
Page 3 Section 6 Prior to Line 14	If unemployed:	If you are currently unemployed, you must complete Lines 14 and 15.
Page 4, Section 6, Line 17:	List your average monthly cost, provide evidence of monthly payments where possible….	List your average monthly costs, and provide evidence of monthly payments where possible….
Page 4 Section 7	Each person applying for a fee waiver request must sign Form I-912. This includes individuals identified in Sections 1 and 2 if 14 years of age or older.	Each person applying for a fee waiver request must sign Form I-912. This includes individuals identified in Sections 1 and 2 if 14 years of age or older. (If you need more space, attach a separate sheet of paper.) (Please add 2 additional rows for “Additional Signature” to correspond with the number of persons (including the applicant) of who may be included on this waiver request listed in Section 2.

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