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FOOD STAMP HANDBOOK §3-1230 (Cont) _...FORMS AND INSTRUCTIONS Handbook

63-1230 STATE FORMS & INSTRUCTIONS (Continued) 83-1230

DFA 285-B (12/83)

For a prospective budget, complete Section D and Sections G through |. For a retrospective budget, complete Sections E through |.

1. Net Monthly Income

After net monthly income has been determined, go to Section J when net income eligibility must also be determined.

lf the household's net income eligibility has already been determined, skip Section J and go to Part 3. ‘

J. Net Income Test

lf the answer on Line J3 is “No”, deny the application, or terminate. or suspend eligibility, as appropriate. If the answer on Line J3 is “Yes”, continue to Part 3.

Part 3 — Benefits

Allotment

Determine if benefits should be prorated and check the appropriate box (Yes or No) in the documentation section. Use the current Tables of Coupon issuance, household size and net monthly income to find the allotment. If benefits should not be prorated, enter the amount from the table. If benefits should be prorated, compute the prorated amount using the date of application

and the appropriate percentage for the month of application from the Reciprocal Table for Prorating First-Month Benefits. Enter the prorated amount.

Supplement

Complete this section if the budget was calculated because of a change and resulted in a supplemental issuance. Enter the amount of the supplement.

Initiais/ Date

Enter EW initials and date after any action in Parts 1, 2, or 3 of the budget worksheet,

Subsequent Budgets

If a subsequent budget is calculated, enter the issuance month, and complete as outlined above.

if a subsequent budget is not calculated but the first-month benefits were prorated, and the

certification period is longer than one month, enter the amount of the household's full allotment for the second month. .

CALIFORNIA-DSS-MANUAL-58 Rev, 1362 replaces Effective 2/15/84

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