Fillable Form I-912 (2018)

What is Form I-912?

Form I-912, Request for Fee Waiver, is a U.S. Citizenship and Immigration Services (USCIS) form used to request a waiver of fees associated with certain immigration applications and petitions. This form is designed for individuals who are unable to afford the fees due to financial hardship. USCIS may waive the fees for applicants who meet specific criteria, such as receiving a means-tested benefit (like Medicaid or Supplemental Nutrition Assistance Program), having a household income below 150% of the federal poverty guidelines, or experiencing other financial difficulties (ie such things relating to a need to register permanent residence in a state, one's lawful permanent resident status, employment authorization, etc).

Form I-912 can be utilized for a variety of applications, including those for Temporary Protected Status (TPS), adjustment of status, and Special Immigrant Juvenile Status (SIJS). These fee waivers are critical for applicants facing financial constraints who need to secure legal residency or employment authorization but cannot afford the application fees. For instance, a Temporary Protected Status recipient may seek a fee waiver to help cover the costs associated with maintaining their lawful presence in the United States, thereby reducing barriers to obtaining essential legal protections and benefits.

How do I fill out Form I-912?

A fillable template for Form I-912 can be found here. USCIS fee waiver eligibility should be checked with the USCIS in order to ensure that you can properly file this form through the correct channels.

Part 1 - Basis for Your Request

Select only one of the following that applies.

• I am, my spouse is, or the head of the household living in my household is currently receiving a means-tested benefit (Complete Parts 2 - 4 and 7-10)
• My household income is at or below 150 percent of the Federal Poverty Guidelines (Complete Parts 2, 3, 5, and 7-10)
• I have a financial hardship (Complete Parts 2, 3, and 6-10)

Part 2 - Information About You

Enter the following information about yourself (the requestor) in the spaces provided

• Full Name
• Other Names Used
• Alien Registration Number
• USCIS Online Registration Number
• Date of Birth
• US Social Security Number
• Marital Status

Part 3 - Applications and Petitions

In the table provided, enter the following information in the relevant columns for the applications and petitions you are requesting a fee waiver for.

• Full Name
• A-Number
• Date of Birth
• Relationship to You
• Forms Being Filed
• Total Number of Forms

Part 4 - Means-Tested Benefits

If you, your spouse, or the head of the household is receiving means-tested benefits, enter the information below for each of them and attach all supporting documentation.

• Full name of person receiving the benefit
• Relationship to you
• Name of agency awarding benefit
• Type of benefit
• Date benefit was awarded
• Date benefit expires or must be renewed

Part 5 - Income at or Below 150 Percent of the Federal Poverty Guidelines

Mark the relevant boxes from the provided options that apply to you for each of the following sections, and answer each question asked if it applies.

Employment Status

• Employed
• Unemployed or Not Employed
• Retired
• Other (provide an explanation)

Unemployment Benefits

Enter the date that you became unemployed, then mark Yes or No to indicate whether or not you are currently receiving unemployment benefits.

Information About Your Spouse

If you are married or separated, answer Yes or No to indicate whether or not you are living together in the same household as your spouse. Then if you answer No, indicate whether or not your spouse is providing financial support to your household.

Your Household Size

Answer Yes or No to indicate if you are the person providing the primary financial support for your household. If you are, enter your name on the line marked “Self” in the table below. If you answered No, enter your name on the line marked “Self”, then enter the head of the household’s name on the line below yours. Enter the following details in the table provided for each member of your household

• Full Name
• Date of Birth
• Relationship to You
• Married
• Full-Time Student
• Income Counted Towards Household Income
• Total Household SIze

Your Annual Household Income

Provide the following information about your annual household income.

• Annual Income
• Total Annual Income of all family members
• Total Additional Income or Financial Support
  • Parental Support
  • Spousal Support
  • Child Support
  • Educational Stipends
  • Royalties
  • Pensions
  • Unemployment Benefits
  • Social Security Benefits
  • Veteran’s Benefits
  • Financial Support from Adult Children, Dependents, or Other People Living in the Household
  • Other (provide an explanation)
• Total Household Income
• Changes since last filed Federal Tax Returns
  • If Yes, explain in the space provided.

Part 6 - Financial Hardship

Provide an explanation or answer for each of the following questions and statements, and provide the requested information in the spaces provided.

• Recent situation(s) that has or have caused you to incur expenses, debts, or loss of income, and the amount lost
• List all cash and/or assets that can be quickly converted into cash
  • Type of Asset
  • Value
  • Total Value
• Total Monthly Expenses and Liabilities
  • Rent and/or Mortgage
  • Food
  • Utilities
  • Child and/or Elder Care
  • Insurance
  • Loans and/or Credit Cards
  • Car Payment
  • Commuting Costs
  • Medical Expenses
  • School Expenses
  • Other

Part 7 - Requestor’s Statement, Contact Information, Certification, and Signature

Mark either one of the boxes under the Requestor’s Statement Regarding the Interpreter to indicate whether you understood all parts of this form or needed the aid of an interpreter to do so. Then, if applicable, mark the box under the Requestor’s Statement Regarding the Preparer.

Requestor’s Contact Information

Enter the following details

• Daytime Telephone Number
• Mobile Telephone Number
• Email Address

Requestor’s Certification

Sign the form in the space provided, then enter the date that the form was signed.

Family Members’ Signatures

Have each family member sign the form in the space provided, then enter the date that the form was signed.

Part 8 - Family Member’s Statement, Contact Information, Certification, and Signature

Mark either one of the boxes under the Family Member’s Statement Regarding the Interpreter to indicate whether you understood all parts of this form or needed the aid of an interpreter to do so. Then, if applicable, mark the box under the Family Member’s Statement Regarding the Preparer.

Family Members’ Signature

Have the family member or members sign the form in the space provided and enter the date that the form was signed.

Part 9 - Interpreter’s Contact Information, Certification, and Signature

Indicate if the person filing this form enlisted the services of an interpreter or not. If not, proceed to Part 10. If they did, indicate if this interpreter was the same one used for all individuals requesting a fee waiver as listed in Part 3.

Then, enter who the interpreter is interpreting for and/or what form(s) they are interpreting for.

Interpreter’s Information

Enter the following information about the interpreter

• Full name
• Mailing Address
  • Street Number and Name
  • Apartment, Suite, or Floor Number
  • City or Town
  • State
  • ZIP Code
  • Province
  • Postal Code
  • Country
• Contact Information
  • Daytime Telephone Number
  • Mobile Telephone Number
  • Email Address

Certification

Enter the language(s) that the interpreter is fluent in in addition to English. Then have them sign the form in the space provided, and enter the date that the form was signed.

Part 10 - Contact Information, Declaration, and Signature of the Person Preparing this Request, if Other Than the Requestor

If any other person prepared this form on your behalf, mark “Yes”. Otherwise, mark No and skip this section. If you marked Yes, indicate whether or not the same preparer was used for all individuals requesting a fee waiver as listed in Part 3.

Then, enter who the preparer is preparing forms for, and what forms they have been preparing on others’ behalf.

Preparer’s Information

Enter the following information about the preparer

• Full name
• Mailing Address
  • Street Number and Name
  • Apartment, Suite, or Floor Number
  • City or Town
  • State
  • ZIP Code
  • Province
  • Postal Code
  • Country
• Contact Information
  • Daytime Telephone Number
  • Mobile Telephone Number
  • Email Address

Preparer’s Statement

Mark whichever of the boxes that applies to indicate whether or not the preparer is an attorney or accredited representative.

Preparer’s Certification

Have the preparer sign the form in the space provided, then enter the date that the form was signed.

Part 11 - Additional Information

In this part, enter all additional information that you did not have the room to enter in earlier parts. If more information still needs to be entered here, use another appropriately labeled copy of this section and attach it to this form.

Frequently Asked Questions (FAQs)

What is a means-tested benefit in relation to Form I-912?

A means-tested benefit is a public benefit based on financial need, like Medicaid or SNAP. If you receive such a benefit, you may qualify for a fee waiver.

What types of immigration applications can include Form I-912?

Form I-912 can be submitted with certain USCIS applications, like Form N-400 (naturalization) or Form I-485 (adjustment of status). The USCIS website lists which forms are eligible for a fee waiver.

Do you need to submit proof of income with Form I-912?

Yes, supporting documents like tax returns, pay stubs, or proof of public benefits are required. These documents demonstrate your financial hardship or eligibility for the waiver.

How do you qualify for a fee waiver using Form I-912?

You qualify by receiving a means-tested benefit, having a household income below 150% of the federal poverty guidelines, or demonstrating financial hardship. The form outlines the eligibility criteria.

Can Form I-912 be filed online?

Currently, Form I-912 must be submitted by mail along with the application for which you’re requesting the fee waiver. Online submission is not available for this form.

What happens if USCIS denies your fee waiver request?

If your fee waiver request is denied, you must pay the required fee to process your immigration application. USCIS will return your application until the fee is paid.

Is there a filing fee for Form I-912?

No, there is no fee to file Form I-912. It is used to request a waiver of other fees.

What information do you need to include on Form I-912?

You need to provide your personal details, information about your household size, income, and any public benefits you receive. Supporting documentation must also be included.

Can multiple family members be included on one Form I-912?Yes, family members applying for immigration benefits at the same time can be included on a single Form I-912. Each family member’s information must be provided.

Do you need to submit a separate Form I-912 for each immigration application?

No, if you’re filing multiple applications at the same time, you can submit one Form I-912 for all related applications. However, you need a new form if you apply for additional benefits later.

What happens if you submit Form I-912 without the required supporting documents?

USCIS may deny the fee waiver request if the necessary supporting documents are not provided. This could delay your application process.

What financial hardship situations might qualify for a fee waiver?

Situations like job loss, medical expenses, or other financial burdens might qualify as hardship. You must explain your circumstances on the form and provide evidence.

How do you prove you receive a means-tested benefit for Form I-912?

You can submit benefit award letters, official statements, or documents from the agency providing the benefit. These documents must show your eligibility and receipt of the benefit.

Can you file Form I-912 if your household income is above 150% of the federal poverty guidelines?

Yes, but you would need to demonstrate financial hardship in another way, such as unexpected expenses or financial obligations. The USCIS reviews each case individually.

How long does it take for USCIS to process Form I-912?

Processing times vary, but it generally takes several weeks to months depending on USCIS caseloads. It’s reviewed along with your immigration application.