FOOD
STAMP COMPUTATION SHEET
1. FIND ADJUSTED INCOME
(a)
Gross earned income/month __________
(b)
Subtract 20% from earned income -__________=__________
(c)
Add other income (DPW, etc.) +_ =__________
(d)
Subtract Standard Deduction - =__________
(HH 1-4=$134; HH
5=$153; HH 6 or more=$175)
(e)
Subtract dependent care cost
($200 per dependent
under age 2)
($175 per dependent
age 2 & over) - _ =__________
(f)
Subtract child support paid
(up to amount of court order, plus
any arrearage paid) -_ =__________
(g)
Subtract medical expenses over
$35 for elderly or
disabled
member in household -_ =__________
Adjusted Income ________(#1)
2. FIND EXCESS SHELTER COSTS
Rent/Mortgage ________
Homeowner’s Insurance ________
Property Tax ________
Standard Utility Allowance:
- Heating or cooling
(h/c) = $374
- Two utilities (not
h/c) = $201
- One utility (not h/c
or phone) = $46
-
Telephone only = $29 ________
Total Shelter Costs (#2)
From Total Shelter Costs (#2) (#2)
Subtract 1/2 of Adjusted Income - (1/2 of #1)
#2 - 1/2 of #1 = Excess Shelter + (#3)
[Standard homeless shelter allowance =
$143]
3. FIND NET INCOME
From Adjusted Income (#1) __________
Subtract Excess Shelter (#3) -__________
(maximum $388, except in HH
w/ elderly or disabled
member)
NET INCOME _________
Subtract 30% of net income from the maximum benefit to determine allotment.
|
Family size |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
+1 |
|
Monthly gross
income limit* |
$1,009 |
$1,354 |
$1,698 |
$2,043 |
$2,387 |
$2,732 |
$3,076 |
$3,421 |
$345 |
|
Max benefit level |
$149 |
$274 |
$393 |
$499 |
$592 |
$711 |
$786 |
$898 |
112$ |
* Applies only to household without an elderly or
disabled member. Disabled may include GA
recipients.
Effective