I-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 Size150% 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 Size150% 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 Size150% 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
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