Temporary Form - Extension of 2009 Federal Poverty Guidelines-2025

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  1. Click ‘Get Form’ to open the Temporary Form - Extension of 2009 Federal Poverty Guidelines in the editor.
  2. Begin by entering your household size in the designated field. This is crucial as it determines your eligibility based on income limits.
  3. Next, locate the section for monthly income. Input your total household monthly income, ensuring it does not exceed the established limits for your household size.
  4. In the signature section, certify that you meet all requirements by signing and dating the form. This confirms that at least one child under age 18 resides in your household and that food received will be used solely for household consumption.
  5. Finally, fill in your street address and any relevant pantry or food bank information before submitting the completed form.

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The 2009 Poverty Guidelines for the 48 Contiguous States and the District of Columbia Persons in familyPoverty guideline 1 $10,830 2 14,570 3 18,310 4 22,0505 more rows
Federal poverty level (FPL) Family size2024 income numbers2025 income numbers For individuals $15,060 $15,650 For a family of 2 $20,440 $21,150 For a family of 3 $25,820 $26,650 For a family of 4 $31,200 $32,1505 more rows
0:12 3:31 Per year for a family of two its 20,40. And for a family of three its $25,820. These numbersMorePer year for a family of two its 20,40. And for a family of three its $25,820. These numbers increase with each additional family member.
I-864P, 2025 HHS Poverty Guidelines for Affidavit of Support Sponsors Household Size100% of HHS Poverty Guidelines*125% of HHS Poverty Guidelines* 2 $19,720 $24,650 3 $24,860 $31,075 4 $30,000 $37,500 5 $35,140 $43,9255 more rows Feb 28, 2025
48 Contiguous States Household/ Family Size2025 Federal Poverty Level for the 48 Contiguous States (Annual Income) 100% 200% 1 $15,650 $31,300 2 $21,150 $42,300 3 $26,650 $53,3006 more rows Jan 17, 2025
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