Intrusction for USCIS Form I-912 - Request for Fee Waiver

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Request for Fee Waiver
USCIS
Form I-912
Department of Homeland Security
OMB No. 1615-0116
U.S. Citizenship and Immigration Services
Expires 03/31/2020
What Is the Purpose of Form I-912?
You may request a fee waiver if you are unable to pay the filing fees or biometric services fees for an application or
petition that is eligible for a fee waiver. When you request a fee waiver, you must clearly demonstrate that you are unable
to pay the fees.
www.uscis.gov/I-912
You can find the list of applications and petitions that are eligible for a fee waiver at
or refer to 8
CFR 103.7(c)(3). For filing tips and additional information, see www.uscis.gov/feewaiver.
You do not need to submit Form I-912 for an application or petition that does not require a filing fee or if you qualify for a
fee exemption based on your immigration status. Refer to the Instructions for each application or petition to see whether
you are exempt from paying the fees.
Forms Eligible for Fee Waiver
Below is a list of applications and petitions U.S. Citizenship and Immigration Services (USCIS) will consider for a fee
waiver and the conditions that must be met to be eligible for a fee waiver. Under current fee waiver regulations, USCIS
can only approve fee waivers for certain forms or certain filings of a particular form type, when fee waiver requirements
are met.
You may file this form to request a fee waiver for any of the following benefit requests or services:
1. Biometric services fee, except for the biometric services fee required for a provisional unlawful presence waiver
application (Form I-601A) filed under 8 CFR 212.7(e);
2. Form EOIR-29, Notice of Appeal to the Board of Immigration Appeals from a Decision of an Immigration Officer;
3. Form I-90, Application to Replace Permanent Resident Card;
4. Form I-129, Petition for a Nonimmigrant Worker, but only if you are an applicant for E-2 CNMI investor
nonimmigrant status under 8 CFR 214.2(e)(23);
5. Form I-131, Application for Travel Document, but only if you are applying for humanitarian parole;
6. Form I-191, Application for Advance Permission to Return to Unrelinquished Domicile;
7. Form I-192, Application for Advance Permission to Enter as Nonimmigrant, but only if you are an applicant who is
exempt from the public charge grounds of inadmissibility;
8. Form I-193, Application for Waiver for Passport and/or Visa, but only if you are an applicant who is exempt from the
public charge grounds of inadmissibility;
9. Form I-290B, Notice of Appeal or Motion, but only if your underlying application was fee exempt, the filing fee was
waived, or it was eligible for a fee waiver;
10. Form I-485, Application to Register Permanent Residence or Adjust Status. A fee waiver is only available if you are
applying for lawful permanent resident status based on:
A. Special Immigrant Status based on an approved Form I-360 as an Afghan or Iraqi Interpreter, or Afghan or Iraqi
National employed by or on behalf of the U.S. Government;
B. An adjustment provision that is exempt from the public charge grounds of inadmissibility of the Immigration and
Nationality Act (INA) section 212(a)(4), such as the Cuban Adjustment Act, the Haitian Refugee Immigration
Fairness Act, continuous residence in the United States since before January 1, 1972, (“Registry”), Asylum Status,
Special Immigrant Juvenile Status, or similar provisions;
Form I-912 Instructions 03/13/18
Page 1 of 11
Request for Fee Waiver
USCIS
Form I-912
Department of Homeland Security
OMB No. 1615-0116
U.S. Citizenship and Immigration Services
Expires 03/31/2020
What Is the Purpose of Form I-912?
You may request a fee waiver if you are unable to pay the filing fees or biometric services fees for an application or
petition that is eligible for a fee waiver. When you request a fee waiver, you must clearly demonstrate that you are unable
to pay the fees.
www.uscis.gov/I-912
You can find the list of applications and petitions that are eligible for a fee waiver at
or refer to 8
CFR 103.7(c)(3). For filing tips and additional information, see www.uscis.gov/feewaiver.
You do not need to submit Form I-912 for an application or petition that does not require a filing fee or if you qualify for a
fee exemption based on your immigration status. Refer to the Instructions for each application or petition to see whether
you are exempt from paying the fees.
Forms Eligible for Fee Waiver
Below is a list of applications and petitions U.S. Citizenship and Immigration Services (USCIS) will consider for a fee
waiver and the conditions that must be met to be eligible for a fee waiver. Under current fee waiver regulations, USCIS
can only approve fee waivers for certain forms or certain filings of a particular form type, when fee waiver requirements
are met.
You may file this form to request a fee waiver for any of the following benefit requests or services:
1. Biometric services fee, except for the biometric services fee required for a provisional unlawful presence waiver
application (Form I-601A) filed under 8 CFR 212.7(e);
2. Form EOIR-29, Notice of Appeal to the Board of Immigration Appeals from a Decision of an Immigration Officer;
3. Form I-90, Application to Replace Permanent Resident Card;
4. Form I-129, Petition for a Nonimmigrant Worker, but only if you are an applicant for E-2 CNMI investor
nonimmigrant status under 8 CFR 214.2(e)(23);
5. Form I-131, Application for Travel Document, but only if you are applying for humanitarian parole;
6. Form I-191, Application for Advance Permission to Return to Unrelinquished Domicile;
7. Form I-192, Application for Advance Permission to Enter as Nonimmigrant, but only if you are an applicant who is
exempt from the public charge grounds of inadmissibility;
8. Form I-193, Application for Waiver for Passport and/or Visa, but only if you are an applicant who is exempt from the
public charge grounds of inadmissibility;
9. Form I-290B, Notice of Appeal or Motion, but only if your underlying application was fee exempt, the filing fee was
waived, or it was eligible for a fee waiver;
10. Form I-485, Application to Register Permanent Residence or Adjust Status. A fee waiver is only available if you are
applying for lawful permanent resident status based on:
A. Special Immigrant Status based on an approved Form I-360 as an Afghan or Iraqi Interpreter, or Afghan or Iraqi
National employed by or on behalf of the U.S. Government;
B. An adjustment provision that is exempt from the public charge grounds of inadmissibility of the Immigration and
Nationality Act (INA) section 212(a)(4), such as the Cuban Adjustment Act, the Haitian Refugee Immigration
Fairness Act, continuous residence in the United States since before January 1, 1972, (“Registry”), Asylum Status,
Special Immigrant Juvenile Status, or similar provisions;
Form I-912 Instructions 03/13/18
Page 1 of 11
11. Form I-539, Application to Extend/Change Nonimmigrant Status, but only if you are an applicant with any benefit
request as specified by INA section 245(l)(7) or an applicant for E-2 Commonwealth of the Northern Mariana Islands
(CNMI) investor nonimmigrant status under 8 CFR 214.2(e)(23);
12. Form I-601, Application for Waiver of Grounds of Inadmissibility, but only if you are an applicant who is exempt
from the public charge grounds of inadmissibility of INA section 212(a)(4);
13. Form I-694, Notice of Appeal of Decision Under Sections 245A or 210 of the Immigration and Nationality Act, if
your underlying application or petition was fee exempt, the filing fee was waived, or was eligible for a fee waiver;
14. Form I-751, Petition to Remove Conditions on Residence;
15. Form I-765, Application for Employment Authorization, unless you are filing under category (c)(33), Deferred Action
for Childhood Arrivals (DACA);
16. Form I-817, Application for Family Unity Benefits;
17. Form I-821, Application for Temporary Protected Status;
18. Form I-881, Application for Suspension of Deportation or Special Rule Cancellation of Removal;
19. Form N-300, Application to File Declaration of Intention;
20. Form N-336, Request for a Hearing on a Decision in Naturalization Proceedings;
21. Form N-400, Application for Naturalization;
22. Form N-470, Application to Preserve Residence for Naturalization Purposes;
23. Form N-565, Application for Replacement of Naturalization/Citizenship Document;
24. Form N-600, Application for Certification of Citizenship; and
25. Form N-600K, Application for Citizenship and Issuance of Certificate under Section 322.
You may also apply for a fee waiver for ANY application or petition that is related to status as a:
1. Battered spouses of A, G, E-3, or H nonimmigrants (such as Forms I-485, I-601 and I-212);
2. Battered spouse or child of a lawful permanent resident or U.S. citizen under INA section 240A(b)(2);
3. T nonimmigrant (such as Forms I-192, I-485, and I-601);
4. Temporary Protected Status (such as Forms I-131, I-821 and I-601);
5. U nonimmigrant (such as Forms I-192, I-485, and I-929); or
6. VAWA self–petitioner (such as Forms I-485, I-601 and I-212).
You may not file Form I-912 if you are requesting consideration DACA. There are no fee waivers for DACA. Fee
exemptions will be available in limited circumstances. See the Deferred Action for Childhood Arrivals Fee exemption
at
www.uscis.gov/forms/forms-and-fees/guidance-exemption-fee-form-i-765-filed-request-consideration-deferred-
action-childhood-arrivals
for more details.
You do not need to file Form I-912 for applications and petitions that do not require a filing fee. Other USCIS
applications and petitions have fee exemption requirements for certain types of applicants and petitioners. In these cases,
the USCIS form and instructions will outline the fee exemption and submission if a separate Form I-912 is not required.
If your form is not listed, please see the specific form instructions for additional information or call the USCIS National
Customer Service Center at 1-800-375-5283.
Form I-912 Instructions 03/13/18
Page 2 of 11
How to File Form I-912
You must file this fee waiver request with all applications and petitions for which you are requesting a fee waiver. You
do not have to file a separate Form I-912 for the filing fee and the biometric services fee. If USCIS approves your Form
I-912, we will waive both the filing fee and biometric services fee.
You may file one Form I-912 for all family-related applications or petitions filed at the same time. For example, if you file
Form I-765, Application for Employment Authorization, and your spouse and children are filing separate Form I-765s at
the same time, you only need to file one Form I-912 for all Form I-765s. You must send all forms together.
General Instructions
USCIS provides all forms free of charge. The latest versions are available at www.uscis.gov/forms. In order to best
view, print, or fill out our forms, you should use the latest version of Adobe Reader, which you can download for free at
get.adobe.com/reader. If you do not have Internet access or have questions about this request, you may call the USCIS
National Customer Service Center at 1-800-375-5283 and ask that we mail a form to you. For TTY (deaf or hard of
hearing) call: 1-800-767-1833.
Signature. Each request must be properly signed and filed. For all signatures on this request, USCIS will not accept a
stamped or typewritten name in place of a signature. If you are under 14 years of age, your parent or legal guardian may
sign the request on your behalf. A legal guardian may also sign for a mentally incompetent person.
Evidence. At the time of filing, you must submit all evidence and supporting documentation required under the Specific
Instructions section of these Instructions.
Copies. You may submit legible photocopies of documents requested, unless these Instructions specifically state that you
must submit an original document. USCIS may request an original document at the time of filing or at any time during
processing of an application, petition, or request. If you submit original documents when not required, the documents
may remain a part of the record, and USCIS will not automatically return them to you.
Translations. If you submit a document with information in a foreign language, you must also submit a full English
translation. The translator must sign a certification that the English language translation is complete and accurate, and that
he or she is competent to translate from the foreign language into English.
How To Fill Out Form I-912
1. Type or print legibly in black or dark blue ink. If a section does not apply to you, type or print “N/A,” which stands
for “not applicable.” Fully and accurately answer all questions that apply to the basis for your request.
2. If you need extra space to complete any item within this request, use the space provided in Part 11. Additional
Information. You may also attach as many separate sheets of paper as needed; type or print your name and Alien
Registration Number (A-Number) (if any) at the top of each sheet and indicate the Page Number, Part Number, and
Item Number to which your answer refers.
Specific Instructions
Part 1. Basis for Your Request
Item Numbers 1. - 3. Select a basis for your request. You are not required to complete the entire section of this request.
Rather, select one basis or more for which you may qualify and complete the corresponding section as explained below in
Parts 4., 5., and 6.
Form I-912 Instructions 03/13/18
Page 3 of 11
Part 2. Information About You (Requestor)
Item Number 1. Full Name. Provide your full name. If you have two last names, include both in the Family Name box
and use a hyphen (-) if appropriate. If you do not have a middle name, type or print “N/A.”
Item Number 2. Other Names Used (if any). Provide all other names you have used, including your maiden name.
Item Number 3. Alien Registration Number (A-Number) (if any). An A-Number is a number assigned by USCIS or
the former Immigration and Naturalization Service (INS). People with A-Numbers can locate the number on their USCIS-
issued or INS-issued documentation. If the intending immigrants you are sponsoring were not previously in the United
States or were only in the United States as tourists, they may not have A-Numbers.
Item Number 4. USCIS ELIS Account Number (if any). If you were issued a USCIS Electronic Immigration System
(USCIS ELIS) Account Number, enter it in the space provided. The USCIS ELIS Account Number is not the same as an
A-Number.
Item Number 5. Date of Birth (mm/dd/yyyy). Provide your date of birth in mm/dd/yyyy format. For example, enter
May 1, 1979, as 05/01/1979.
Item Number 6. U.S. Social Security Number (if any). Provide your U.S. Social Security number.
Item Number 7. Marital Status. Indicate your current marital status.
Part 3. Applications and Petitions for Which You are Requesting a Fee Waiver
Item Number 1. Complete the table for yourself and each person requesting a fee waiver with you. Provide the form
numbers and the total number of applications and petitions for which you and any family members are requesting a fee
waiver.
Part 4. Means-Tested Benefits
Item Number 1. If you, your spouse, or the head of household living with you receives a means-tested benefit, complete
the table. You must attach supporting documentation. If you provide sufficient proof that you receive a means-tested
benefit, your fee waiver will generally be approved.
A means-tested benefit is a public benefit where a person’s eligibility for the benefit, the amount of the benefit, or both,
is based on the person’s income and resources. USCIS will consider means-tested benefits that are Federally, state, or
locally funded and granted by the benefit agency.
Examples of means-tested benefit programs are Medicaid, Supplemental Nutrition Assistance Program (known as
“SNAP” and formerly called Food Stamps), Temporary Assistance to Needy Families (TANF), and Supplemental Security
Income (SSI), among others. Consult with your benefit-granting agency or your legal advisor to determine whether any
Federal, state, or local public benefit that you may receive qualifies as a means-tested benefit.
For the purposes of determining an inability to pay the filing fee of the petition or application, the following are not
considered means-tested benefits: Medicare; unemployment benefits; Social Security retirement benefits; Social Security
Disability Insurance (SSDI); Social Security Retirement, Survivors, and Disability Insurance (RSDI); or student financial
aid.
1. Individual Receipt of a Means-Tested Benefit
A. The individual may demonstrate that he or she is personally receiving a means-tested benefit.
B. If a child is the sole applicant, he or she may provide an individual means-tested benefit or a custodial parent’s
means-tested benefit, if living in the same household.
C. If multiple children are filing at the same time, each child must have an individual receipt of a means-tested
benefit or be under the parent’s household who is receiving a means-tested benefit.
2. Family Members’ Means-Tested Benefits
A. Your spouse and unmarried children under 21 years of age living with you will normally qualify for a fee waiver
as part of your household if you are receiving means-tested benefits.
Form I-912 Instructions 03/13/18
Page 4 of 11
B. If your spouse is receiving a means-tested benefit, you will normally qualify for a fee waiver as long as you are
residing with your spouse and are not legally separated.
C. You may not use a means-tested benefit received by a child or household member, other than a spouse, as the
basis for eligibility in Part 4. Means-Tested Benefits, but you may use it to support a fee waiver request in Part
5. Income at or Below 150 Percent of the Federal Poverty Guidelines or under Part 6. Financial Hardship if
the award letter or benefit approval document indicates the total household income.
D. If you are 21 years of age or older, you cannot use a parent’s means-tested benefits (such as SSI), even if the
parent is living with you, as evidence of your eligibility for a fee waiver. However, you may use this information
to support a fee waiver request in Part 5. Income at or Below 150 Percent of the Federal Poverty Guidelines
or under Part 6. Financial Hardship if the award letter or benefit approval document indicates the total
household income and you are otherwise eligible under those criteria.
3. Documentation
A. To qualify for a fee waiver, the evidence that you provide must demonstrate that you are currently receiving the
means-tested benefit. This evidence can be in the form of a letter, notice, or other agency documents that indicate
that the benefit is being received.
B. Documentation must contain:
(1) Your name (or the name of the person receiving the benefit);
(2) The name of the agency granting the public benefit;
(3) The type of benefit; and
(4) An indication that the benefit is currently being received (for example, a recently dated letter or document
with effective dates, date of renewal or period the approval ends, if available).
C. If the documentation is more than 12 months old and the benefit is still being received, provide additional
evidence that shows the benefit is currently being received.
Part 5. Income at or Below 150 Percent of the Federal Poverty Guidelines
To qualify for the fee waiver, your household income must be at or below 150 percent of the Federal Poverty Guidelines,
at the time of filing, based on your household size. The Federal Poverty Guidelines are established by the Secretary of the
Department of Health and Human Services annually. To obtain information on the current Federal Poverty Guidelines,
visit our Web site at
www.uscis.gov/I-912P
and review Form I-912P, Poverty Guidelines for Fee Waiver Request.
Your Employment Status
Item Number 1. Employment Status. Indicate your current employment status. If you are both employed and a
student, select Other and provide an explanation.
Item Number 2. Indicate if you are currently receiving unemployment benefits. If applicable, provide the date that you
became unemployed and include the total amount of unemployment benefits you have received in Item Number 7.
Information About Your Spouse
Item Number 3. Indicate whether your spouse is living with you. If your spouse lives with you, list your spouse in the
table provided in Item Number 4. If applicable, indicate whether your spouse provides any financial support to your
household. If your spouse provides any financial support to your household, include any contributions that your spouse
provides to your household in Item Number 7.
Your Household Size
Item Number 4. Indicate whether you are providing the primary financial support for your household.
Complete the table with the information requested about the members of your household including their names, dates of
birth, relationship to you, whether the person is married, whether the person is a full-time student, and whether the person
earns income counted towards household income.
Form I-912 Instructions 03/13/18
Page 5 of 11

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