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APPENDIX E

5 Effective: April 1, 2026

LIHEAP Income Inclusion and Exclusion Chart Income types Definition Considered Income? Proof of Income Yes No Self-Employment Income (Business, Uber, Lyft, Food Carrier, etc.) Income from a business, less business expenses. X Most recent federal tax returns, including 1040 and Schedule “C”. Self-employment Self Certification Form (Appendix G), bank statements and any required supporting documentation. Senior Companion Program A program which offers an opportunity for volunteers aged 60 and over to provide companionship and support to homebound adults, most of whom are also seniors. X SNAP (Food Stamps) (See Food Stamps.) X Social Security Benefits (SS, SSD, SSI) A federally funded program of social insurance and benefits which include retirement income, disability income, benefits paid to minors, and death and survivorship benefits. X Official documentation such as award letter, benefit verification letter or annual letter from Social Security Administration (SSA), bank statement, or SNAP documents may be used. Strike Benefits Benefit from Union Action. X Copy of check, statement from Union. Student Aid (See also Work Study.) The full amount of all financial assistance paid directly to the student or to the educational institution. This includes: scholarships, grants, or loans. X Temporary Assistance For Needy Families (TANF) A program which provides assistance to needy families so that children may be cared for in their own homes or in the home of relatives. X Documentation showing amount of assistance. Training Stipend Income received from a training program by applicant. X Pay stubs