933.03 Required Verification SR 12-17, 05/12 (FAM-A)

Require verification of gross monthly income at application and at each subsequent eligibility determination.

The individual must provide verifications according to the following table:

Type of Income	Acceptable Verifications
Earned income & Unearned income	Third-party documentation, such as pay stubs, that indicates the type of income, the gross amount, frequency, and source of payment. *
Self-employment	*A profit and loss statement or the entire IRS tax filing of the previous calendar year, if filed.
Contributions	A signed and written statement from the contributor which indicates the gross amount and frequency of payment.

Exception: If a third party is unable or unwilling to provide verification, accept a signed and witnessed statement from the individual that indicates the type, gross amount, source, and frequency of the income.