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Effective Date: 
4/1999

Documents

Instructions

Updated: 1/2002

Purpose

To provide a worksheet for computing the applied income of a legal parent disqualified for citizenship, state time limits, unmarried minor parent domicile requirement, a stepparent, or an alien sponsor; and countable income of a legal parent when income is diverted.

Procedure

When to Prepare

Use Form H1100 when budgeting for cases with a disqualified legal parent, a legal parent with income diverted, noncertified stepparent, alien sponsor with income. Transfer to the Form H1101 or Form H1102, the amounts entered in shaded items.

Number of Copies

Complete one copy of Form H1100 in ink.

Recording Requirements

Record the verification of income on Form H1100. Attach an additional page if necessary. Attach Form H1100 to the corresponding Form H1101/Form H1102.

Form Retention

The requirements are listed in the Manager's Guide for Eligibility Programs.

Detailed Instructions

STEP 1 — Applied Income of a legal parent disqualified for citizenship, state time limits, or unmarried minor parent domicile requirement

Complete Step 1 if a legal parent with income is disqualified for citizenship, state time limits, or unmarried minor parent domicile requirement. If a stepparent with income is also in the home, complete Step 2 before Step 1.

Line 1 – Gross Earned — Enter the gross earned income (including net self-employment) of the disqualified legal parent.

Line 2 – Work-Related Expense Deduction — Enter the standard amount for the parent's work-related expenses.

Line 3 – Net Earned Income — Subtract line 2 from line 1 and enter the amount. If no income remains, enter 0.

Line 4 – Parent's Other Income — Enter all other income of the legal parent.

Line 5 – Total Adjusted Income — Enter the total of line 3 and line 4.

Line 6 – Payments to Dependents Outside the Home — Enter the actual amount of any payments made to persons living outside the home whom the parent can claim as tax dependents or is legally obligated to support.

Line 7 –Alimony and Child Support Payments — Enter the actual amount of alimony or child support payments the parent makes to persons outside the home.

Line 8 — Enter the budgetary (100%) needs figure for the parent and all noncertified members in the home he can claim as tax dependents or is legally obligated to support including SSI recipients. (Do not include the needs of a dependent who is disqualified for a reason other than citizenship, state time limits, or unmarried minor parent domicile requirement.) Use the single parent caretaker case needs figure if the parent's needs are included (caretaker case with second parent if a noncertified stepparent or another parent disqualified for citizenship, state time limits, or unmarried minor parent domicile requirement is also in the home).


Note: See A-1424 to determine

  • whether to use the needs allowance of an adult or a child, or
  • the needs amount for more than two adults.

Line 9 – Applied Income — Subtract lines 6,7, and 8 from line 5 and enter the remainder. Enter 0 if no income remains. Enter on Form H1101, Step 1, line 9. Note: Enter the gross income amounts on Form H1000-A/B in the applicable income fields. Enter the deductible amounts of work-related expenses and/or diverted income in Item 58 on Form H1000-A/B. Do NOT enter deductions for an individual that exceed his income.

STEP 2 – Applied Income of Stepparent

Complete step 2 for cases with a noncertified stepparent to determine the amount of income to be applied from the stepparent's income.

Line 1 – Gross Earned by Stepparent — Enter the stepparent's gross earned income.

Line 2 – Work-Related Expense Deduction — Enter the standard amount for the stepparent's work-related expenses.

Line 3 – Net Earned Income — Subtract line 2 from line 1 and enter the amount. If no income remains, enter 0.

Line 4 – Other Income of Stepparent — Enter all other income received by the stepparent.

Line 5 – Total Adjusted Income — Enter the total of line 3 and line 4.

Line 6 – Payments to Dependents Outside Home — Enter the actual amount of any payments made to individuals living outside the home that the stepparent can claim as tax dependents or is legally obligated to support.

Line 7 – Alimony and Child Support Payments — Enter the actual amount of alimony and child support payments the stepparent makes to persons outside the home.

Line 8 – Remaining Income — Subtract line 6 and line 7 from line 5 and enter the amount. If no income remains, enter 0.

Line 9 – 100% Needs of Stepparent and Non-cert. Dep. — Enter the caretaker case budgetary (100%) needs figure for the stepparent and all noncertified members in the home that he can claim as tax dependents. Use the two parent needs figure if the legal parent is also in the home but receives SSI or is disqualified for citizenship or state time limits.

Notes:

  • See A-1424 to determine
    • whether to use the needs allowance of an adult or a child, or
    • the needs amount for more than two adults.
  • Do not include the needs of a dependent who is disqualified for a reason other than citizenship or state time limits.

Line 10 – Remaining Needs/Applied Income — Subtract line 9, from line 8 and enter the amount.

  • If there is remaining income in line 10, apply this amount to the certified group as unearned income on Form H1101/Form H1102, Income Worksheet, Step 1, line 15.

    If line 10 is zero or has remaining income and there is a legal parent in the home who also has income, complete Step 1 or Step 3 on Form H1100 as applicable. When completing Step 1 or Step 3, do not apply any income from Step 2 and do not divert an amount for the needs of the stepparent and noncertified dependents in the home.

  • If an unmet needs amountremains in line 10, the stepparent's income does not meetthe needs of the stepparent and noncertified dependents in thehome. Do not apply any income to the certified group on FormH1101/Form H1102. If a legal parent also has income, complete Step 3 enteringin line 4 the remaining needs from Step 2, line 10. (If a legal parentdisqualified for citizenship or state time limits has income, completeStep 1 rather than Step 3. Enter in line 8, Step 1, the remainingneeds from Step 2, line 10.)

STEP 3 — Diverting Income of a Legal Parent

Complete Step 3 if a caretaker, a second parent, or a legal parent who is disqualified for a reason other than citizenship, state time limits, or unmarried minor parent domicile requirement has income that must be diverted before determining the countable amount for the certified group. Also complete Step 3 if a noncertified stepparent lives in the home and only the legal parent has income, or they both have income and the stepparent's income does not meet all of his and the noncertified dependent's needs in Step 2. If both the stepparent and legal parent have income, complete Step 2 before Step 3.

Line 1 – Payments to Dependents Outside Home — Enter the actual amount of any payments made to persons living outside the home whom the parent can claim as tax dependents or is legally obligated to support.

Line 2 – Alimony and Child Support Payments — Enter the actual amount of alimony or child support payments the parent makes to persons outside the home.

Line 3 – 100% Needs Amount — Enter the budgetary (100%) needs figure for all noncertified members in the home the legal parent can claim as tax dependents or is legally obligated to support including SSI recipients, except do not include the needs of a parent/dependent who is disqualified for a reason other than citizenship/alien status, state time limits, or unmarried minor parent domicile requirement. Use the single parent caretaker case needs figure if there is a noncertified stepparent in the home, or a second legal parent in the home who receives SSI or is disqualified for citizenship/alien status, state time limits, or noncompliance with the unmarried minor parent domicile requirement. Note: See A-1424 to determine

  • whether to use the needs allowance of an adult ora child, or
  • the needs amount for more than two adults.

Line 4 – Maximum Amount to be Diverted — Enter the total of lines 1, 2, and 3 (except if Step 2 is also completed, follow instructions in Step 2 to enter remaining needs in line 4 if necessary). This is the maximum amount of diversions that can be deducted from the individual's total income. The actual amount diverted in any needs test on Form H1101 may be less, since the diverted amount cannot exceed the individual's total income and be deducted from income of another household member unless they will be filing a joint tax return or they are married.


Note: If there is a diversion amount entered in Line 4 and someone other than the individual with diversions has countable income to be entered on Form H1101, compute their incomes on separate Forms H1101 in each income test until after subtracting the actual amount to be diverted as noted above.

STEP 4 — Applied income of Alien's Sponsor

Use this step if an alien has a sponsor with income.

Line 1 – Total Unearned Income — Enter the total unearned income of the sponsor (and spouse).

Line 2 – Total Gross Earned Income + Net from Self-employment — Enter a total of the sponsor's (and spouse's) income from employment and the net amount from any self-employment.

Line 3 – 20% of Gross Earnings (Including Net Self-employment) — Enter the lesser of

  • 20% of the gross earned income (including monthlynet self-employment income), or
  • $175.

Line 4 – Subtotal — Subtract line 3 from line 2 and enter the amount.

Line 5 – Total Adjust Income — Enter the total of lines 1 and 4.

Line 6 – Payments to Dependents Outside Home — Enter the actual amount the sponsor pays to individual outside the home that the sponsor can claim as tax dependents.

Line 7 – Alimony and Child Support Payments — Enter the actual amount of alimony and child support the sponsor pays to individuals outside the home.

Line 8 – Needs of Sponsor and Dependents — Enter the budgetary (100%) needs figure for the sponsor and members of his household he can claim as tax dependents. Do not include the needs of the TANF children. Note: See A-1424 to determine

  • whether to use the needs allowance of an adult ora child, or
  • the needs amount for more than two adults.

Line 9 – Applied Income — Subtract lines 6, 7, and 8 from line 5 and enter the amount in line 9. If there is remaining income apply it to the certified group as unearned income on Form H1101/Form H1102, Income Worksheet, Step 1, line 10.