|
Step 1 | ||
---|---|---|
Earned Income (Gross Wages) | $ | |
Subtract General Exclusion | – $20.00 | |
Subtract Earned Income Exclusion | – $ 65.00 | |
Equals Countable Earned Income
|
= $ | |
Step 2 | ||
Divide Countable Earned Income by 2 | ÷ 2 | |
Division answer | = $ | |
Subtract Division answer from Countable Earned Income | – $ | |
Equals Final Revised Countable Earned Income |
= $_______ |
|
Step 3 | ||
Maximum SSI Benefit ( Federal Benefit Rate ) | $________ | |
Subtract Final Revised Countable Earned Income | – $________ | |
Equals New Monthly SSI Benefit |
= $_______ |
|
Step 4 | ||
Earned Income (Gross Wages) | $______ | |
Plus New Monthly SSI Benefit | + $______ | |
Equals Total Monthly Gross Income |
= $_______ |
STEP 1 | ||
Unearned Income (SSDI, VA, Pension, Annuity, etc.) | $________ | |
Subtract General Exclusion | – $20.00 | |
Equals Countable Unearned Income |
= $________ | |
STEP 2 | ||
Earned Income (Gross Wages) | $______ | |
Subtract Earned Income Exclusion | – $ 65.00 | |
Equals Countable Earned Income |
= $_______ |
|
STEP 3 | ||
Countable Earned Income (from Step 2) | $________ | |
Divide by 2 | ÷ 2 | |
Division answer | = $________ | |
Subtract Division answer from Countable Earned Income | – $________ | |
Equals New Countable Earned Income |
= $_______ |
|
STEP 4 | ||
Countable Unearned Income (from Step 1) | $_______ | |
Plus New Countable Earned Income (from Step 3) | + $_______ | |
Equals Final Total Countable Earned and Unearned Income |
= $_______ |
|
STEP 5 | ||
Maximum SSI Benefit (Federal Benefit Rate) | $_______ | |
Subtract Final Countable Earned and Unearned Income (from Step 4) |
– $_______ |
|
Equals New SSI Cash Benefit |
= $_______ |
|
STEP 6 | ||
Gross Earned Income | $________ | |
Plus new SSI Benefit (from Step 5) | + $________ | |
Plus Total Unearned Income (from Step 1) | + $________ | |
Equals Total Monthly Gross Income |
= $_______ |