Form I-942P Guidelines TOC

I942P-FRM-TOC-WIP-12142016.docx

REQUEST FOR REDUCED FEE

Form I-942P Guidelines TOC

OMB: 1615-0133

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TABLE OF CHANGES – FORM

Form I-942P, Income Guidelines for Reduced Fees

OMB Number: 1615-0016

Date: 12/14/2016


Reason for Revision: I-942P creation under the 2016 fee rule.


Current Page Number and Section

Current Text

Proposed Text

Page 1,

2016 Annual HHS Poverty Guidelines*

[new]

[page 1]


2016 Annual HHS Poverty Guidelines*


To qualify for a reduced fee, documented annual household income must be greater than 150 percent but not more than 200 percent of the Federal Poverty Guidelines at the time of filing.


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


1

2

3

4

5

6

7

8

+8


150% of HHS Poverty Guidelines*


$17,820

$24,030

$30,240

$36,450

$42,660

$48,870

$55,095

$61,335


Add $6,240 for each
additional person.


200% of HHS Poverty Guidelines*


$23,760

$32,040

$40,320

$48,600

$56,880

$65,160

$73,460

$81,780


Add $8,320 for each
additional person.


For Alaska:


HHS Poverty Guidelines*


Household Size


1

2

3

4

5

6

7

8

+8


150%


$22,260

$30,030

$37,800

$45,570

$53,340

$61,110

$68,880

$76,680


Add $7,800 for each
additional person.


200%


$29,680

$40,040

$50,400

$60,760

$71,120

$81,480

$91,840

$102,240


Add $10,400 for each
additional person.


For Hawaii:


HHS Poverty Guidelines*


Household Size


1

2

3

4

5

6

7

8

+8


150%


$20,505

$27,645

$34,785

$41,925

$49,065

$56,205

$63,345

$70,515


Add $7,170 for each
additional person.


200%


$27,340

$36,860

$46,380

$55,900

$65,420

$74,940

$84,460

$94,020


Add $9,560 for each
additional person.


*Use these poverty guidelines for Form I-942, Request for Reduced Fee, from December 23, 2016 until new guidelines go into effect in 2017.




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