ALL OTHER HOUSEHOLDS, including WIC households, follow these intsructions:
Part 1: List each participant's name
Part 2: Skip this section
Part 3: Follow these instructions to report total household income from last month:
Column A - Name: List the first and last name of each person living in your household, related or not (such as grandparents, other relatives, or friends who live with you). You must include yourself and all children living with you.
Column B - Gross income last month and how often it was received: Next to each person's name, list each tpe of income received last month, and how often it was received.
List the gross income each person earned. Gross income is the amount earned before taxes and other deductions. The amount should be listed on your pay stub, or your employer can tell you - this is not the same as take-home pay. This amount includes ALL INCOME SOURCES (employment income, welfare, child support, alimony, social security, pensions, retirement, Worker's Compensation, unemployment, regular contributions from people not living in your household, VA benefits, disability benefits and all other benefits).
Next to the amount, type how often the person received it (weekly, every other week, twice a month, monthly, etc.)
Column C - Check if no income: If the person does not have any income, check this box.
Part 4: An adult household member must type their full name and include the last four digits of his or her Social Security Number, or mark the box if he or she does'nt have one.
Part 5: Answer this question if you choose to.