This page is displayed for each type of other income you indicated that a household member receives on the previous pages. If this was indicated by mistake, remove the record once you reach the
Other 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 get money from other income sources, click the Previous button to navigate back to the Other Income Survey 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.
Gross payment refers to the amount this person earns before taxes are taken out. A copy of check or award letter should have the gross amount listed.
When entering gross payment, only enter two decimal places. Special characters, such as commas, are not allowed (e.g., $1250.00).
Add Another?
To add another other income source, select Yes to the last question.
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.