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Fillable Printable Form I-864P

Fillable Printable Form I-864P

Form I-864P

Form I-864P

Form I-864P 03/01/17 N
2017 HHS Poverty Guidelines for Affidavit of Support
Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS
Form I-864P
Supplement
Page 1 of 1
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:
Sponsor's Household Size125% of HHS Poverty Guidelines*
For Alaska:For Hawaii:
2
3
4
5
6
7
8
$20,300
$25,525
$30,750
$35,975
$41,200
$46,425
$51,650
Add $5,225 for each
For sponsors on active duty in the
U.S. Armed Forces who are petitioning
for their spouse or child
100% of HHS Poverty Guidelines*
$16,240
$20,420
$24,600
$28,780
$32,960
$37,140
$41,320
Add $4,180 for each
additional person.
For all other sponsors
Sponsor's
Household Size
For sponsors on active
duty in the U.S. Armed
Forces who are
petitioning for their
spouse or child
100% of HHS
Poverty Guidelines*
125% of HHS
Poverty Guidelines*
For all other sponsors
Sponsor's
Household Size
For sponsors on active
duty in the U.S. Armed
Forces who are
petitioning for their
spouse or child
100% of HHS
Poverty Guidelines*
125% of HHS
Poverty Guidelines*
For all other sponsors
2
3
4
5
6
7
8
$25,362
$31,900
$38,437
$44,975
$51,512
$58,050
$64,587
Add $6,537 for each
$20,290
$25,520
$30,750
$35,980
$41,210
$46,440
$51,670
Add $5,230 for each
2
3
4
5
6
7
8
$23,337
$29,350
$35,362
$41,375
$47,387
$53,400
$59,412
Add $6,012 for each
additional person.
additional person.additional person.additional person.additional person.
Means - Tested Public Benefits
Programs Not Included: The following Federal and State programs are not included as means-tested benefits: emergency Medicaid; short-term,
non-cash emergency relief; services provided under the National School Lunch and Child Nutrition Acts; immunizations and testing and treatment
for communicable diseases; student assistance under the Higher Education Act and the Public Health Service Act; certain forms of foster-care or
adoption assistance under the Social Security Act; Head Start Programs; means-tested programs under the Elementary and Secondary Education
Act; and Job Training Partnership Act programs.
Federal Means-Tested Public Benefits. To date, Federal agencies administering benefit programs have determined that Federal means-tested public
benefits include Food Stamps, Medicaid, Supplemental Security Income (SSI), Temporary Assistance for Needy Families (TANF), and the State
Child Health Insurance Program (SCHIP).
State Means-Tested Public Benefits. Each State will determine which, if any, of its public benefits are means-tested. If a State determines that it has
programs which meet this definition, it is encouraged to provide notice to the public on which programs are included. Check with the State public
assistance office to determine which, if any, State assistance programs have been determined to be State means-tested public benefits.
* These poverty guidelines remain in effect for use with Form I-864, Affidavit of Support, from March 1, 2017 until new guidelines go into
effect in 2018.
Minimum Income Requirements for Use in Completing Form I-864
2017 HHS Poverty Guidelines*
$18,670
$23,480
$28,290
$33,100
$37,910
$42,720
$47,530
Add $4,810 for each
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