PM 08-01-01

new informationSee policy memorandum dated 10/03/13 Verifications for Medical Programs.

new informationSee Medical Morsel dated 04/01/14 Electronic Verifications for Medical Programs.

Sources for earned income information include:

Pay Stubs

New TextThe Work Number
Employer's Statements
AWVS Clearance
Pay Envelopes
Wage Tax Receipts
Self-employment Bookkeeping Records
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Current Business Records for Self Employed Persons
Employee's W-2 Form
State or Federal Income Tax Return
Sales and Expenditure Records
Employer's Wage Records
State Income Tax Bureau

Information may be provided on:

  •  Request for Employment Verification (Form 266),
  •  Request for Employment Verification (AABD)(Form 266A),
  •  Request for Employment Verification (AABD Computerized) (Form 266ACF),
  •  Request for Employment Verification (Computerized)(Form 266CF), or
  •  Income Statement for Persons Paid in Cash (FHP for children only)(Form 266AK).

Figure all earned income in monthly amounts. See WAG 10-02-00 for budgeting nonexempt earned income.

The IRS requires employees to use IRS Form 4070 to report tips to their employer. Use this form to verify tips that are not included on the employee's wage stubs. If no verifications are available, accept the client's statement about the amount of tip income.