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APPENDIX E

1 Effective: April 1, 2026

LIHEAP Income Inclusion and Exclusion Chart

Income types Definition Considered Income? Proof of Income Yes No Adoption Assistance Financial assistance and medical coverage granted to an adoptive family to offset the short-and long-term costs of adopting an eligible child.

X

Alimony An allowance paid to a person by that person’s spouse or former spouse for living expenses. X Court documents, written statement from person paying support, DHI form. Annuities A specified income payable at stated intervals for a fixed or a contingent period, often for the recipient’s life. X Statement from investment firm, bank statement. Cash Gifts - Irregular Contributions Irregular cash gifts or payment on behalf of the household also includes loans and cash draw down on credit cards. X Cash Gifts - Regular Contributions Must provide regular support for an individual or for the household, paid directly to the household. X Written statement from person providing support, LHC form Child Support Money paid for the care of one’s minor child.

X

DHS Cash Assistance (SNAP in the form of cash assistance instead of food stamps) See also Food Stamps. Cash assistance deposited directly into household bank account. X Dividends A sum of money paid to shareholders of a corporation out of earnings.

X Letter from corporation declaring amount, bank statement.