Other Income Type Selection

This page is displayed because you told us that someone has a type of income other than SSI, Social Security, Child Support, or a job.

 

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.

 

For each household member, select the other type of income that that person receives. You can select multiple other income types in each category. If none of the other income types apply to a household member, check the None box. You cannot select None in addition to another income type.

 

Other Types of Income:

 

Training Allowance (WIA) – if you receive any money to attend training, you should check this box.

 

Roomer or Boarder – if you receive money from a person for living in your house, who is not a relative or spouse, you should check this box.

 

Trust Income – if you receive payments from a trust fund, you should check this box.

 

Rental Income – if you receive payments from an investment property, you should check this box.

 

Scholarships/Grants/School Loans – if you receive money to attend school, you should check this box.

 

Tribal Money – if you receive money from a tribal affiliation, you should check this box.

 

Oil Lease/Royalties – if you receive money from any oil leases or royalties, you should check this box.

 

Loans – if you receive money as repayment to a loan you made someone, you should check this box.

 

Spousal Support/Alimony - if you receive money from your ex-husband or ex-wife, you should check this box.

 

Disability Insurance Benefits - if you receive payments because you are unable to work due to a disability, you should check this box.

 

Energy Check - if you receive benefits to help pay your energy costs, you should check this box.

 

Interest Income - if you earn interest on a bank account, stock, or other asset, you should check this box.

 

Military Allotment - if you receive money from serving in the military, you should check this box. Do not check this box if you are receiving veteran benefits or combat pay only.

 

Gifts - if a friend, relative or other person gives you money (other than child support, maintenance or alimony), you should check this box.

 

Annuity Income - if you receive payments from an annuity, you should check this box. An annuity is an investment similar to a life insurance policy that pays money each year (or on a regular basis) to the person with the annuity.

 

Retirement Pension - if you receive any type of pension or retirement payments other than Social Security or Railroad Retirement, you should check this box.

 

Railroad Benefits - if you receive retirement payments from the Railroad Retirement Board, you should check this box.

 

Adoption Subsidy- if your adoption was subsidized, you should check this box

 

Oil Lease/Royalties- if you receive any type of royalties for leasing your oil, you should check this box.

 

Supplemental Security Income (SSI) – If you receive SSI, you should check this box.

 

Social Security – If you receive social security income, you should check this box.

 

Unemployment Compensation – If you receive compensation due to unemployment, you should check this box.

 

Worker’s Compensation – If you receive worker’s compensation, you should check this box.

 

Child Support Income – If you receive child support income, you should check this box.

 

Contributions from Friends and Family – If you receive any type of contribution from friends or family, you should check this box.

 

Veteran’s Benefits – if you receive payments or income for being a veteran, you should check this box.

 

Other Income - if you have a type of income other than the ones listed here, you should check this box.

 

None – if the person does not receive any of these types of income, you should check this box.

 

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.

 

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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.