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83-1230 (Cont.) FORMS AND INSTRUCTIONS Handbook

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

DFA 288-D (12/83) 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. tf 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

Compiete this section if the budget was calculated because of a change and resulted in a suppiemental issuance. Enter the amount of the supplement,

Initials / 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, check if the budget calculation is retrospective or prospective and complete as outlined above.

If a subsequent budget is not calculated but the first-month benefits were prorated, and the certification period is fonger than one month, enter the household’s full allotment for the second month,

Worksheet for Changes and Other Documentation

Part 4 — Resources

Sections | and J need not be completed for a household in which all members are receiving AFDC,

1. Motor Vehicles

Use this section to record household motor vehicle changes. Each vehicle must be treated

separately to determine its countable resource amount. Thereafter, each amount is added to determine the total vehicle resource amount.

1. Complete the items for each vehicle using information provided by the household. A vehicle is licensed if the motor vehicle registration fees are paid for the current year. If not ficansed, skip 3 through 5 and go directly to 6.

CALIFORNIA-DSS-MANUAL-SS_ Rev. 1370 replaces Issue 2193 Effective 2/15/84

(MANUAL LETTER NO R4.121 fola\