Addendum G

Income Grid

Income Types

Definition

Considered Income - Yes

Considered Income - No

Proof of Income

Adoption Subsidy Subsidy payment to parents who adopted a special needs child.

X

 

 
Adult Public Assistance (APAAdult Public Assistance) Gross regular and adjustments or recoupment payments from Public Assistance.

X

 

EISEligibility Information System screens (APBH/APIH), current award letter, statement from worker
AHFCAlaska Housing Finance Corporation Mortgage Payments (UAPUtility Allowance Payment) UAPUtility Allowance Payment payments are cash payments to the household and noted on the AHFCAlaska Housing Finance Corporation worksheet.

X

 

AHFCAlaska Housing Finance Corporation worksheet
Alaska General Relief Assistance (GRAGeneral Relief Assistance) Alaska General Relief Assistance.

 

X

 
Alaska Longevity Bonus See Senior Benefits.

 

X

 
Alaska Native Corporation Payments Alaska Native Claims Settlement Act (ANCSAAlaska Native Claims Settlement Act), Alaska Native corporation payments.
 

 

X

 
Alaska Temporary Assistance (ATAPAlaska Temporary Assistance Program) Gross regular and adjustments or recoupment payments from Public Assistance.

X

 

EISEligibility Information System screen (TABH/TAIH), award letter, worker statement
Alaska Senior Benefits (GAGeneral Assistance) Alaska Senior Assistance and Alaska Native Elder Assistance.

 

X

 
Alimony Support from an absent family member or someone not living in the household. Child support or alimony payment made directly to a mortgage company on behalf of a client is considered income.

X

 

EISEligibility Information System screen (CANOCase Notes), court order showing amount awarded, check stub
Annuities/insurance, pension, retirement, and disability benefits Annuity payments paid quarterly shall be averaged over the three months and counted as monthly income. Annuity payments paid annually shall be averaged over twelve months and counted as monthly income.

X

 

EISEligibility Information System screen (CANOCase Notes), benefit statement letter, year-end statement, R-1099
APAAdult Public Assistance (Adult Public Assistance) Gross regular and adjustments or recoupment payments from Public Assistance.

X

 

EISEligibility Information System screens (APBH/APIH), current award letter, statement from worker
ATAPAlaska Temporary Assistance Program (Alaska Temporary Assistance Program) Gross regular and adjustments or recoupment payments from Public Assistance.

X

 

EISEligibility Information System screens (TABH/TAIH), award letter, statement from worker
Basic Allowance for Housing (BAHBasic Allowance for Housing) Military housing allowance.

X

 

Copy of checks/stub
BIABureau of Indian Affairs General Assistance When paid directly to the household.   Paid to the vendor.   General Assistance Program burial payments made to a vendor are excluded as income.

X

 

 

X

 

 

X

EISEligibility Information System screen (CANOCase Notes), check stub, letter from BIABureau of Indian Affairs office
Bingo and lottery winnings  

X

 

EISEligibility Information System screen (CANOCase Notes), Bingo/Pull Tab Statement, letter from provider
Capital gains Any profit that results from investments into a capital asset, such as stocks, bonds or real estate, which exceeds the purchase price.

X

 

IRS form 1040, EISEligibility Information System screen (CANOCase Notes)
Cash gifts That do not exceed a total of $20 per month per individual in the household.

 

X

EISEligibility Information System screen (CANOCase Notes), HAPHeating Assistance Program application, statement from person providing cash gifts
Cash-out Pension or Retirement  

X

 

Benefit statement, year-end statement, current pay stubs showing gross
Cash payments Including payments to household from a wage earner not residing with the household because of his or her employment, or an absent parent family member or someone not living in the household.

X

 

EISEligibility Information System screen (CANOCase Notes), copies of checks/stubs, work statement
Child support Support from an absent family member or someone not living in the household. Child support or alimony payment made directly to a mortgage company on behalf of a client is considered income. Payments received from the non-custodial parent or a child support enforcement agency, including full or partial monthly obligation payments, payments toward obligation arrearage, and voluntary payments.   Payments paid by the non-custodial parents to a third party to pay for a household expense.   CSSDChild Support Services Division pass-through payments paid through DPADivision of Public Assistance or a Native Family Assistance Program agency to a TANFTemporary Assistance to Needy Families recipient.

X

 

CSSDChild Support Services Division screen, a signed statement from the non-custodial parent, EISEligibility Information System screen (CANOCase Notes), court order showing amount awarded, check stub, stated on application, the TAIH screen on EISEligibility Information System showing the issuance of a pass-through payment.
COLA Cost of living allowance.

X

 

Copy of checks/stub
Combat Pay Additional payment received by a member of the U.S. Armed forces deployed to a designated combat zone is excluded income for the duration of the deployment if the additional pay is the result of deployment to or while serving in a combat zone, and it was not received immediately prior to serving in the combat zone.

 

X

Pay stub
Conservation Innovation Grants (CIG) NRCSNational Resource Conservation Service funding opportunity for agriculturalists to stimulate development of conservation approaches.

X

 

 
Contract for deed Consider annual interest payment.

X

 

Annual interest statement
Crime Victims Benefits  

 

X

 
Declaration of Personal Income Irregular income resulting from occasional sources such as yard work, childcare, collecting cans/bottles, donating blood/plasma, payments from sale of personal belongings, house, boat, loan repayments, escrow payments, etc.

X

 

Client statement on HAPHeating Assistance Program application.
Deposits Made into bank accounts owned or jointly owned by the household, unless identified as income previously considered.

X

 

Copy of bank statement
Disability benefits Payment from:   - Veterans disability benefit   - Social Security disability insurance   - SS-Ds Supplemental Security Income (SSISupplemental Security Income)   - State of Alaska Adult Public Assistance (APAAdult Public Assistance or IAInterim Assistance)   - Disability retirement benefits from a government agency because of a disability considered permanent, or   - Railroad Retirement Act (below)   - EXCEPTIONS: Veterans benefits provided to children of Vietnam veterans (including adult children) who were born with the congenital defect of spinal bifida, benefits paid to children of women, Vietnam veterans, born with certain other birth defects.

X

X

 

 

EISEligibility Information System screen (CANOCase Notes), current benefit statement, bank statement (VAVeteran Affairs disability benefits are not subject to deductions) or call VAVeteran Affairs Office 1-800-827-1000
Diversion payments TA payment

X

 

EISEligibility Information System Screen (GAIH)
Dividends, interest, & royalties From non-native corporations, investments, stocks.   Excluded: PFDPermanent Fund Dividends received by household members, and first $2,000 Native Corporation dividends.

X

 

Letter declaring amounts, bank statements
Dividends, Native Alaska Native Claims Settlement Act (ANCSAAlaska Native Claims Settlement Act). Alaska Native corporation payments to shareholders and Alaska after first $2,000 exempted income.

 

X

 
Earned Income Tax Credits Any Earned Income Credit displayed on a pay check should be deducted from the gross income. EICEarned Income Credit is not counted as income.

 

X

Checks/stubs
Education Income Education assistance that is not funded under Title IV of the Higher Education Act or the Bureau of Indian Affairs student assistance program funds is excluded as income if it is used or will be used for paying tuition, fees, or other necessary education expenses at any educational institution, including vocational, technical, and correspondence schools, and schools for people with disabilities. See Exception below.

 

X

 

Education Income

Any portion of education assistance that is not used or set aside for paying tuition, fees, or other necessary education expenses is countable unearned income.

X

 

 
Escrow Income  

X

 

Letter declaring monthly amount, bank statement
Excess Reimbursements When payments received as an advance or reimbursement for volunteer job training or work-related services exceed the expense incurred, the excess amount is included as income.

X

 

 
Federal income tax refunds  

 

X

 
Food Stamps (aka SNAPSupplemental Nutrition Assistance Program)  

 

X

 
Foster Care Households receiving foster care income may choose not to count foster care income if they do not consider the foster child/adult to be a member of their household. In these cases, the foster child/adult is not counted as a household member. A foster adult not considered a member of the household must be considered a household sharer, or room renter.

X

 

Check stubs, EISEligibility Information System screen (CANOCase Notes)
General Relief Assistance Payments State of Alaska General Relief Assistance Program payments paid on behalf of the household to a vendor for household expenses such as rent, food, fuel, clothing, utilities, house repair, transportation, and burial are exempt.

 

X

In Regs, exempt.
G.I. Bill payment  

X

 

Current award letter, checks/stub
Housing Allowance In kind, non-cash housing is exempt.   Housing allowances as cash on a pay stub is countable income.

 

X

X

 
Ineligible Alien Households with household members that are:   - ineligible alien, - non-U.S. Citizen, - failure to provide a social security number   We count their income but they will not be counted as a household member.

X

 

Wage stubs or statement from employer specifying gross wages, EISEligibility Information System screen
Inheritance  

X

 

Letter regarding conditions of payments
In-kind/non-cash income Any gain or benefit that is not in the form of money in exchange for food and shelter, produce from a garden, clothing, non-cash employee benefits, such as the Legal Trust benefit provided to State of Alaska employees, and non-cash assistance such as the Medicare Part D Low-Income Subsidy. All bona fide loans, including educational, personal, and commercial loans, are disregarded as income. A bona fide loan is a debt that the borrower has an obligation to repay and expresses his or her intention to repay.

 

X

The nature of a loan must be verified and documented in the case file. Commercial and educational loans: a copy of written loan agreement or any document identifying the payment as a loan. Personal loans: must provide acknowledgment by the borrower and lender that there is an obligation to repay the loan.
Interest Bank or investment interest

X

 

Bank Statement
Interim Assistance (IAInterim Assistance) Interim Assistance. Gross regular and adjustments or recoupment payments from Public Assistance.

X

 

EISEligibility Information System screen (APBH/APIH)
JOBSJob Opportunities and Basic Skills Alaska Job Opportunities and Basic Skills allowances.

 

X

 
JTPAJob Training Partnership Act The Job Training Partnership Act of 1983.

 

X

 
Jury duty pay & witness fees Jury duty payments and witness fees count as earned income. Any portion of a jury duty payment or witness fee that is designated as a reimbursement for items such as food, lodging, parking, or transportation is excluded as income. Exception: Jury duty payments issued directly to the employer is exempt income.

X

 

Copy of check, check stub, official letter
Loans Money received from an educational, personal, commercial, or other loan for which the borrower has an obligation to repay.

 

X

 
Lottery Winnings Lottery winnings paid on an annual basis shall be averaged over twelve months and counted as monthly income.

X

 

 
Lump sum payments Unless specified as not countable.

X

 

 
MASSTMature Alaskans Seeking Skills Training (Title V) Allowances, earnings, and payments from an employer and funded by the Mature Alaskans Seeking Skills Training program (MASSTMature Alaskans Seeking Skills Training), federally known as the Senior Community Service Employment Program (SCSEPSenior Community Service Employment Program) is administered under Title V of the Older Americans Act, P. L. 100-175.

 

X

Wage stubs or statement from employer specifying gross wages, EISEligibility Information System screen (CANOCase Notes)
Military Pay When a household member is deployed, the deployed person's income is counted as household income, except that portion paid directly to the deployed person for expenses. Also add in their COLACost of Living Allowance and BAHBasic Allowance for Housing.

 

NOTE ON MILITARY PAY: The income on the Leave and Earnings Statement is considered a single monthly repayment, even when military personnel receive a mid-month paycheck. For example, a military person receives a mid-month check on November 15 and the end of the month check on November 30. The November, showing income for November 1 through 30, is received December 1. The income shown on this is countable income for November. See Combat Pay.

 

SAVESystematic Alien Verification for Entitlements Pay is excluded military income.

X

X

Leave and Earnings Statement, EISEligibility Information System screen (CANOCase Notes)
Money from 3rd Party Funds provided and used for the care of a third party beneficiary who is not a household member (third party payee) are exempt. For example, a household receives child support for a child not living in the home. The household sends the child support to the child. This child support is not income to the household. This also includes situations where separate households share rent and one household receives a rent payment from the other and pays the landlord. The household that pays the landlord would not have the money counted as income that was given to it by the other household to pay the rent.

 

X

 
Native Dividends Native Corporation Dividends. First $2,000 is exempt, additional dividends after the first $2,000 are countable, per person per year.

X

X

Dividend Check stub or 1099
Native Elders Assistance Tribal payments to elders because they are elders.

 

X

 
Natural Resource Conservation Grants Grants awarded through the NRCSNational Resource Conservation Service to improve water management and/or improve resource conditions.

X

 

Copy of the grant award or letter showing the total grant amount and the time period of the award (6 months, 1 year, 2 years.)
Offsets (DOLDepartment of Labor) Dept. of Labor offsets. Per 7 AAC 44.040 I "The department will calculate the household's gross monthly income by counting total cash receipts before taxes, earned and unearned, derived from any source by any member of the household in the calendar month before the date of signature on the completed application."

X

 

 
Other Income Income will be attributed to the household from individuals not considered to be household members. These situations include:   Households with a member disqualified as an ineligible alien or for failure to provide a social security number or declare citizenship. The excluded member's income is countable income.

X

 

Acceptable verification depends on the type and source of income.
Other Income Sale of personal property, house, boat, car, receipt of a loan payment, escrow payment, etc.

X

 

 
PASS Child Care Payments PASS I, II, and III Child Care payments paid to persons for their child care expenses are excluded income. These payments are countable earned income to the child care provider.

 

X

 
Pensions  

X

 

EISEligibility Information System screen (CANOCase Notes), benefit statement, year-end statement, R-1099
PERS/TRS State of Alaska retirement plans, including cash-outs.

X

 

EISEligibility Information System screen (CANOCase Notes), benefit statement, year-end statement, current pay stubs showing gross amount
PFD Alaska Permanent Fund Dividend.   Exception: A PFDPermanent Fund Dividend received by the household by a non-household member. This would be considered countable income.

 

X

EISEligibility Information System screen (CANOCase Notes), bank statement
Public Assistance Public Assistance income includes TANFTemporary Assistance to Needy Families payments (Alaska Temporary Assistance Program and Native Family Assistance) and Adult Public Assistance payments (Aid to the Disabled, Aid to the Blind, Old Age Assistance, and Interim Assistance).

X

 

EISEligibility Information System screen or Native Family Assistance Agency.
Railroad Retirement Act payments An annuity payment under the Railroad Retirement Act and determined to be eligible to receive Medicare or determined disabled.

X

 

Current award letter EISEligibility Information System screen (CANOCase Notes), year-end statement, R-1099
Recoupment Monies withheld from an assistance payment, earned income, or other income source or monies received from any income source which is voluntarily or involuntarily returned, to repay a prior overpayment from that income source.

X

 

 
Reduction for Fraud Reductions due to Fraud: When a TANFTemporary Assistance to Needy Families or APAAdult Public Assistance benefit is reduced to repay a fraud overpayment, the calculation of the food stamp allotment will use the TANFTemporary Assistance to Needy Families or APAAdult Public Assistance amount the household would have received without the grant reduction. This applies only if a formal fraud finding was determined by the administrative disqualification process or a conviction by court.

X

 

 
Reimbursements Payments received for reimbursement of expenses incurred in connection with employment, such as travel, meals, mileage, training, or per diem reimbursement, payments received for reimbursement of medical expenses and reimbursements made to an individual serving as a volunteer.

 

X

 
Rental Income Rental income (gross income minus costs of doing business). Costs of doing business may include the mortgage, taxes, and insurance.   Note: Rental income received in a lump sum shall be averaged over the months of intended use and counted as monthly income.

X

 

 
Retirement & SBS Payments or cash-outs.

X

 

 
Reverse Mortgage Payments from a reverse mortgage.

 

X

 
Room Renter Count the rent but don't count the room renter as part of the household.

X

 

Rent receipt, EISEligibility Information System screen (CANOCase Notes), last year's HAPHeating Assistance Program case
SAVESystematic Alien Verification for Entitlements PAY Military Pay that is not countable income.

 

X

See MS 3003-5 B 2 b
Seasonal Work A regular season of 11 months or less. May include fishing, logging, school district, tourism, fire fighting jobs.

X

 

Completed seasonal work statement, DOLDepartment of Labor (BTWI), 1099 form, final settlement statement (fishing)
Self-Employment Net self-employment income for the previous 12-month period after allowable deductions. Self-employment includes occupations such as small business, crafts, boarding house manager/owner, ownership of rental property, and seasonal self-employment such as fishing.

X

 

Completed self-employment form, IRSInternal Revenue Service 1040 + Schedule C income tax form, DOLDepartment of Labor (BTWI)   Acceptable: tax and bookkeeping records, account statements. Written verification of self-employment income and expenses are required.
Senior Benefits Per our regulations – exempt.

 

X

 
SNAPSupplemental Nutrition Assistance Program (formerly known as Food Stamps)  

 

X

 
Social Security Advances This income is a loan from a financial institution to a person receiving direct deposit SSASocial Security Administration income. It is paid to the bank when the month SSASocial Security Administration benefit is received.

 

X

 
Social Security Benefits (SSISupplemental Security Income/SSASocial Security Administration) Social Security benefits (SSASocial Security Administration) – retirement, survivor's disability and dependents benefits; Supplemental Income (SSISupplemental Security Income) – aged, blind, and disabled person's benefits, and Veterans benefits are considered unearned income.

X

 

Award letters, SVES SDX/Bendex, EISEligibility Information System screen (CANOCase Notes), a statement from Social Security, last year's HAPHeating Assistance Program case
SSISupplemental Security Income Payment – Exception The portion of the SSISupplemental Security Income payment that is deducted as a payee fee, up to 10% of the monthly benefit not to exceed $35* is excluded. If the client's disability is based on drug addiction or alcoholism, the fee can be 10% of the monthly benefit not to exceed $68*. To qualify to collect a payee fee, the organization must be a community based nonprofit social service agency. (*Fee amounts effective December 2007).

 

X

 
Stock & Bonds  

X

 

Letter regarding condition of payment, bank statement
Strike Benefits Cash payments, including payments to a household from a wage earner not residing with the household because of his or her employment.

X

 

Copy of check, statement/Union.
Student Reimbursements or Allowances Any payment made under Title IV of the Higher Education Act or under BIABureau of Indian Affairs student assistance programs is entirely excluded. Other educational income that is either used or intended to be used for allowable educational expenses is excluded.

 

X

 
Student Loans Grants  

 

X

Award Letters, billing statements, statement from household
Student Study grants Also known as Work-Study grants.

 

X

 
Student Wages Wages received by a half-time student less than 18 years of age (this exclusion continues during semester breaks and summer vacation) and who is not the head of household. Use the date and signature to determine if the person was 18 years old at the time of application.

 

X

 
Subsidized Adoption payments Including adoption stipends

X

 

EISEligibility Information System screen (CANOCase Notes) or Native Family Assistance agency, 3rd party
Supplemental Security  

X

 

SVES, benefit statement, last year's HAPHeating Assistance Program case
TANFTemporary Assistance to Needy Families Temporary Assistance for Needy Families. Gross regular and adjustments or recoupment payments from Public Assistance.

X

 

EISEligibility Information System screen (CANOCase Notes) or Native Family Assistance agency, TANFTemporary Assistance to Needy Families records or check stub
Tips or Gratuities  

X

 

Pay stubs that list the tips, EISEligibility Information System screen (CANOCase Notes), client statement
Title IV Higher Education Act and Bureau of Indian Affairs Student Assistance Programs: Pell, Byrd Scholars, LEAPLeveraging Educational Assistance Partnership, SLEAPSpecial Leveraging Educational Assistance Partnership, Upward Bound, SIGStudent Incentive Grants, Stafford, Perkins, Work-Study, etc.

 

X

Award Letter or Contact awarding institution
Title V (CSEPCommunity Service Employment Program) Received by senior citizens under the CSEPCommunity Service Employment Program and/or MASSTMature Alaskans Seeking Skills Training

 

X

 
Trade Readjustment Act (TRATrade Readjustment Act)  

X

 

 
Trust Disbursements to the individual     Income to a Special Needs Trust Monthly payments to the client. Only count disbursements received from the trust account by the client during the month.   Paid to a third party payee for client. SSASocial Security Administration, SSISupplemental Security Income, or Inheritances.

X

X

Statements from trust regarding disbursements amount, EISEligibility Information System screen (CANOCase Notes)
Unemployment Insurance (UIBUnemployment Insurance Benefits) Direct deposits benefits are counted as income on the date of issuance, including amounts garnished, off-sets/recoupment.

X

 

DOLDepartment of Labor screen BB53, statements from other states re: disbursements amounts, EISEligibility Information System screen (CANOCase Notes)
Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 The following payments are excluded as income under Title II: payments to persons displaced as a result of the acquisition payments to a displaced homeowner toward the purchase of a replacement dwelling (such payment may only be to a displaced owner who purchases and occupies a dwelling within one year following displacement); replacement housing payments to a disabled person not eligible for a homeowner's payment.

 

X

 
Vendor payments Cash payments made by a person or organization outside of a household directly to a vendor or provider to meet expenses for a household. Including former spouse paying rent/mortgage.

X

 

Statement from person providing the payment, copies of checks/stubs, EISEligibility Information System screen
Veterans Retirement Benefits For Retired Military Personnel, that are veterans, but not disabled. Different from Veterans Disability Benefits.

X

 

Current award letter, EISEligibility Information System screen, year end statement, R-1099. Retiree Account Statement, which will show income tax deductions.
Veterans Disability Benefits  

X

 

Bank statement permitted since these payments have no deductions.
Veterans [Vietnam] Disability Benefits Veterans benefits provided to children of Vietnam veterans (including adult children) who were born with the congenital defect spinal bifida, benefits paid to children of women, Vietnam veterans, born with certain other birth defects.

 

X

 
Veterans Voc Rehab Schools  

 

X

 
Veterans Voc Rehab Housing  

X

 

 
Victims of Crime Any payment received from a fund established by a State to aid victims of crime is excluded from income.

 

X

 
Vocation Rehabilitation Payments Payments made to or on behalf of a household member by the division of vocational rehabilitation, DOLWD, for purposes related to training programs in which the individual is enrolled.

 

X

 
Volunteer Payments Any payments (salary, wages, stipend, or reimbursements) paid to volunteers under the Senior Corp and AmeriCorps programs of the Corporation for National and Community Services (CNCSCorporation for National and Community Service) are excluded income: AmeriCorps-State and National AmeriCorps-VISTAVolunteer In Service To America AmeriCorps-NCCCNational Civilian Community Corps – National Civilian Community Corps Foster Grandparents RSVPRetired Senior Volunteer Program – Retired & Senior Volunteer Corps Senior Companion Program

 

X

Volunteer status and participation in an exempt program must be verified
Volunteers Payments received for support services or reimbursement of out-of-pocket expenses, such as lunches or transportation, made to an individual serving as a volunteer.

 

X

 
Wages Wages and salaries before any deductions or garnishments, cost of living allowance (COLACost of Living Allowance), leave cash-outs, vacation pay, bonuses, training stipends, and back-pay. Including commissions, bonuses, profit sharing, tips, stipends, severance pay, sick leave, royalties, and honoraria which result from the client's work service, cash advances. Income from babysitting, housekeeping, craft sales, fishing, etc. is considered wages unless the applicant is claiming self-employment.

X

 

Employer's statement signed and dated, employer's wage record, paycheck stub, collateral contact with the employer, EISEligibility Information System screen (CANOCase Notes)
Wage Withholding Wages held by an employer without the employee's approval are exempt income, except for garnishments.

 

X

 
WICWomen, Infant and Children Payments or benefits received under the Women, Infant, and Children Program (WICWomen, Infant and Children) are exempt.

 

X

 
Workers Compensation Gross income including recoupments and adjustment payments.

X

 

FAX, email, or statement from Workers Comp, EISEligibility Information System screen (CANOCase Notes)
Workforce Investment Act On the job training program: earnings paid to persons participating in on-the-job training under a Workforce Investment Act (WIAWorkforce Investment Act) program are exempt when the person earning the money is under 19 years old. WIAWorkforce Investment Act earnings paid to persons 19 years or older are countable earned income.

 

X

Employer's statement signed and dated, employer's wage record, paycheck stub, collateral contact with the employer, EISEligibility Information System screen
Work-Study Earned Income College or university students may be enrolled in a work-study program in which they attend school part-time and work part-time at a job. Any income a household or recipient earns from employment in a work-study program will not be counted as income.

 

X

This disregard applies to both adults and children. The worker must verify that part-time employment of recipient who claims to be in a work-study program is in fact in a work-study job and not an individually acquired regular part-time job.

 

 

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                             2024-03 (12/24)