Document checklist · I-912

The form whose fee you ask to waive, in the same envelope

Where to find it: One I-912 covers every family form you send together.

Clear copies of each document, not originals

Where to find it: A copy shop, or your phone camera in good light with the whole document in the frame.

Letter or notice from the agency showing the benefit you receive

Basis 1: if you or a family member receive Medicaid, SNAP, TANF, SSI, or another means-tested benefit

Where to find it: The most recent approval or renewal letter; if it is over 12 months old, add something current.

Your most recent federal tax return, or last month's pay stubs, W-2, or SSA-1099

Basis 2: if your household income is at or below 150% of the federal poverty guideline

Where to find it: Your copy of the 1040 or the irs.gov transcript; if you did not file, pay stubs or an employer letter.

Proof of income for each working person in your household

Basis 2, for each person in your household who earns money

Where to find it: Their return or pay stubs; if someone has no income, explain it on the form.

Documents for other help or income you receive

Basis 2, if you receive child support, a pension, Social Security, unemployment, or other regular help

Where to find it: The support order or payment record, the agency letter, or your bank statement.

Proof of the financial hardship

Basis 3: a medical emergency, unemployment, lost hours, eviction, or another hardship

Where to find it: Medical bills, a termination letter, an eviction notice, bank statements, and expense receipts.

English translation of any document in another language

Only if a document is not in English

Where to find it: Anyone fluent in both languages can translate and sign the certification with their name, date, and contact details.