| Self-Employment Income & Expenses |
Yes-Self empl. records for 30 days prior to the application date (02-07-03-h & Action Memo 12/23/03) |
Yes-Self empl. records for  the last 30 days, use best estimate if needed (02-07-03-h & 13-02-01) |
Yes-Same as FS (02-07-03-h & 10-01-01) |
| Earnings from Employment |
Yes-One pay stub dated in the last 30 days (02-07-03-h & Action Memo 12/23/03) |
Yes-All pay stubs dated within the last 30 days, use best estimate if needed (02-07-03-h & 13-02-01) |
Yes-Same as FS |
| Other Income |
Yes-Proof of one payment in the last 30 days (02-07-03-h & Action Memo 12/23/03) |
Yes-Proof of all income for the last 30 days, use best estimate if needed (02-07-03-h & 13-02-01) |
Yes-Same as FS |
| Assets |
NA |
Yes (02-07-03-i) |
Yes (02-07-03-i) |
| Housing Cost |
NA |
Yes (02-07-03-l) |
NA |
| Utilities |
NA |
Not verified - accept statement |
NA |
| Residence |
Not verified - accept statement |
Yes (02-07-03-d) |
Not verified - accept statement unless questionable |
| Immigration Status |
Yes- Except for noncitizens under age 19 and for Emergency Medical; for pregnant women, proof is not required, but desirable if available (02-07-03-c & 03-01-04) |
Yes (02-07-03-c & 03-01) |
Yes (02-07-03-c & 03-01) |
| Citizenship |
Yes-Do not deny if proof can not be obtained (Policy Memos 7/01/06, 7/19/06, 8/17/06 & 7/25/07) |
Yes-only if born outside the U.S.(02-07-03-c) |
Yes-Same as Food Stamps |
| Identity |
Yes-Do not deny if proof can not be obtained (Policy Memos 7/01/06, 7/19/06, 8/17/06 & 7/25/07) |
Yes (02-07-03-l) |
Not verified |
| Relationship |
Not verified - accept statement |
Not verified |
Yes (02-07-03-g) |
| Presence in the Home |
Not verified - accept statement |
Not verified |
Yes (02-07-03-e) |
|
SSN
(1) See note below
|
Not verified - accept statement(03-11-01) |
Yes-Except for expedited FS (02-08-03) |
Yes-(03-11-01) |
|
Medical Expenses
(2) See note below
|
Yes-Only if determining Family Health Spenddown (17-04-02) |
Yes-Only if claimed for a qualifying member (age 60 or older or disabled) (05-06-02 & 13-01-05-a) |
NA |
| Pregnancy |
Yes-If eligibility is based on pregnancy (02-07-03-j & 06-09-01) |
NA |
Yes-If eligibility is based on pregnancy (02-07-03-j) |
| Child Support Paid |
Yes- Proof of one payment in the last 30 days (15-04-02-f & Action Memo 12/23/03) |
Yes-Proof of all payments made in the last 3 fiscal months (02-07-03-l) |
Yes-Court ordered support (10-01-04) |
| Child Care Expenses |
Not verified - accept statement |
No |
Yes-If meeting an Adult/Teen/Child Care Disregard criterion (08-01-02-d) |
|
Financial Management
(3) See note below
|
NA |
Yes (02-07-03-l & 02-08-03-c) |
No |
