Employment Details

This page is displayed because you indicated someone in the household has a job, will begin a new job, or just ended a job. This page will repeat for each member who was indicated to have a job. If this was indicated by mistake, remove the record once you reach the Job Income Summary page at the completion of this section of the Redetermination/Change Report/Simplified Report.

 

If the individual indicated at the top of the page does not have a job, click the Previous button to navigate back to the Job Income Summary page to adjust the information entered.

 

Some items have an asterisk (*) next to them, indicating they are mandatory. You must fill in these items before you can continue to the next page.

 

Employer

 

Address Line 1 and Address Line 2 fields should only contain letters, numbers and ‘-‘, ‘#’, and ‘/’. City should only contain letters. Zip Code should contain only numbers.

 

Job End

 

When entering Gross amount of last paycheck, only enter two decimal places. Special characters such as commas:(,) are not allowed (e.g., $1250.00).

 

Payment Information

 

When entering Total Gross Amount and Hourly rate of pay, only enter two decimal places. Special characters such as commas :(,) are not allowed.

 

When entering hours worked, enter how many hours worked per pay period. A pay period may be more than one or two weeks.

 

Add Another?

 

If there is more job information that you need to add, select Yes to the question(s) in this section.

 

Click the Print button to print this page for your reference.

 

Click the Next button to save and continue with the online Redetermination/Change Report/Simplified Report.

 

Click the Save & Exit button to exit the online Redetermination/Change Report/Simplified Report and save your progress on your Redetermination/Change Report/Simplified Report. The Redetermination/Change Report/Simplified Report is saved as Incomplete.

 

For Redeterminations and Change Reports

 

Strike

 

Enter the date the household member went on strike.