933.03 Required Income Verification (FAM)

___________________________________________________________

Require verification of gross monthly income at application and at each subsequent eligibility determination.

The individual must provide verifications according to the following table:

Type of Income	Acceptable Verifications
Earned income	Third-party documentation, such as pay stubs, that indicates the type of income, the gross amount, frequency, and source of payment. *
Earned income that fluctuates month to month	Pay stubs, or a statement from the employer stating the monthly amount earned.
Earned income that fluctuates season to season	Either the previous year’s tax return or a statement from the employer.
Earned income that cannot be verified and is anticipated to fluctuate over the next 12 month period	A statement from the employer identifying an estimate of future earnings during the upcoming 12 months.
In-kind compensation	A statement from the employer.
Unearned income	Third-party documentation, such as pay stubs, a statement from the contributor, physical documentation, or collateral contact that indicates the type of income, the gross amount, frequency, and source of payment.
Unearned income that fluctuates	Pay stubs, a written statement from the contributor, physical documentation, or collateral contact.
Self-employment income	A current profit and loss statement or the entire IRS tax filing of the previous calendar year, if filed.
Contributions of monies	A written and signed statement from the contributor, which indicates the gross amount and frequency of payment.

*If an income change causes benefits to decrease, first attempt to obtain verification through physical documentation or collateral contact. If unable to obtain verification through collateral contact, verify the change based on the information the client provided. No additional paper verification is needed.

When reported household income is over 85% of State Median Income (SMI) and the increase is temporary (less than 3 months) require a written, signed and dated statement from the source of payment or payer indicating the income increase is temporary.

References: He-C 6910.09(f), RSA 167:83,II(c) and (o), 45 CFR 98.20