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PrintI-912P Supplement, 2020 HHS Poverty Guidelines for Fee Waiver Request
Use the HHS Poverty Guidelines to complete Form I-912, Fee Waiver Request.
These poverty guidelines are effective beginning Jan. 15, 2020.
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 |
| 1 | $19,140 |
| 2 | $25, 860 |
| 3 | $32,580 |
| 4 | $39,300 |
| 5 | $46,020 |
| 6 | $52,740 |
| 7 | $59,460 |
| 8 | $66,180 |
| Add $6,720 for each additional person |
For Alaska:
| Household Size | 150% of HHS Poverty Guidelines |
| 1 | $23,925 |
| 2 | $32,325 |
| 3 | $40,725 |
| 4 | $49,125 |
| 5 | $57,525 |
| 6 | $65,925 |
| 7 | $74,325 |
| 8 | $82,725 |
| Add $8,400 for each additional person |
For Hawaii:
| Household Size | 150% of HHS Poverty Guidelines |
| 1 | $22,020 |
| 2 | $29,745 |
| 3 | $37,470 |
| 4 | $45,195 |
| 5 | $52,920 |
| 6 | $60,645 |
| 7 | $68,370 |
| 8 | $76,095 |
| Add $7,725 for each additional person |
