Form I-942P Poverty Guidelines

Income Guidelines for Reduced Fees

USCIS
Form I-942P

Department of Homeland Security
U.S. Citizenship and Immigration Services

Supplement

2016 Annual 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:

DRAFT
NOT FOR
PRODUCTION
10/18/2016

Household Size

150% of HHS Poverty Guidelines*

200% of HHS Poverty Guidelines*

1

$17,820

$23,760

2

$24,030

$32,040

3

$30,240

$40,320

4

$36,450

$48,600

5

$42,660

$56,880

6

$48,870

$65,160

7

$55,095

$73,460

8

$61,335

$81,780

+8

Add $6,240 for each
additional person.

Add $8,320 for each
additional person.

For Alaska:

For Hawaii:

HHS Poverty Guidelines*

HHS Poverty Guidelines*

Household Size

150%

200%

Household Size

150%

200%

1

$22,260

$29,680

1

$20,505

$27,340

$30,030

$40,040

2

$27,645

$36,860

3

$37,800

$50,400

3

$34,785

$46,380

4

$45,570

$60,760

4

$41,925

$55,900

5

$53,340

$71,120

5

$49,065

$65,420

6

$61,110

$81,480

6

$56,205

$74,940

7

$68,880

$91,840

7

$63,345

$84,460

8

$76,680

$102,240

8

$70,515

$94,020

2

+8

Add $7,800 for each Add $10,400 for each
additional person.
additional person.

+8

Add $7,170 for each Add $9,560 for each
additional person.
additional person.

* These poverty guidelines remain in effect for use with Form I-942, Request for Reduced Fee, from December 20, 2016 until new
guidelines go into effect in 2017.

Form I-942P 10/12/16

Page 1 of 1