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• Required maintenance charges or homeowner fees from condominium, cooperative, or homeowners' association. Alternative verification: Statement from the homeowner's association or management company, or by payment receipt. • Utilities

• If community spouse lives in government subsidized housing, do not deduct for utilities unless the spouse receives notice that an excess utility charge will be added to the rent and reports it to the local agency. Treat as a change and redetermine the spousal income allowance for the remainder of the a/b’s c.p.

• For all others, deduct the standard amount from Table C. If the community spouse has roomers or boarders, count them in the household size.

2. The monthly shelter standard is $812.00.

If total shelter costs are less than or equal to the $812.00 shelter standard:

a. Make no deduction for shelter costs.

b. The Basic Allowance from VI.B.2.b., above, is the spousal income allowance. STOP.

3. If total shelter costs exceed the $812.00 shelter standard:

a. Subtract the shelter standard from the total shelter costs.

b. The result is excess shelter expense.

4. Add the excess shelter in 3 above, to $2705.00, up to the maximum community spouse income allowance of $4067.00. (This amount changes yearly in January.)

a. If the combined total is less than $4067.00:

(1) Subtract community spouse's gross monthly income from the combined total.

(2) This amount is the spousal income allowance.

b. If total is equal to or exceeds the $4067.00 community spouse income standard:

(1) Subtract community spouse's gross monthly income from the community spouse income standard.

(2) This amount is the spousal income allowance.

Docusign Envelope ID: 950E9248-29CC-8930-81BC-BCEC667EB493