Page 26 - Arizona

Proof of Eligibility:
Guidelines and Examples

*Both sides must be uploaded

Income Based Eligibility Documents

2020 Federal 135% Poverty Guidelines for Arizona

Household Income
Members Guidelines
1 member $17,226
2 members $23,274
3 members $29,322
4 members $35,370
5 members $41,418
6 members $47,466
7 members $53,514
8 members $59,562
Add’l members $6,048

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Proprietary and Confidential 1/20/2020