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Page | 97 c. Unearned Income – identify the type (SSI, TANF, TWEP, rental, VA, child support, Reemployment Assistance, etc.) the amount, how often received and how it was verified d. Explain how prospective income was computed, what information was used to come up with the amounts? e. Does the DLR query indicate anything unusual, if so, how was it resolved? f. If employment has terminated, explain circumstances and if is a job quit penalty is applicable? If not, why is good cause allowed? g. If no income, how is the household meeting personal needs or other household expenses. h. Document that the gross income guideline sheet was reviewed and given to the household.
11. Shelter Costs/Residency: a. Residency verification is required at application. If they have moved during the renewal period, it must be re-verified. If they have not moved, then residence verification is not required at renewal. b. How is the residence address verified? c. Does the applicant have expenses for rent, lot rent, mortgage, tax, insurance? If so, list each amount and how it was verified. d. Does the household have utility expenses? If so, what type of deduction allowed and how was it verified? e. If there are multiple households, how are the shelter expenses divided? f. If there are shelter expenses, but no income, how is the household paying shelter expenses?
12. Child Care: a. Is the household billed, and do they pay for child care expenses for work, school or training? b. If a child care expense is not allowed, why? c. Does the household receive child care assistance?
13. Child Support Expense: a. Does the household pay child support? To whom is it paid? b. Is the support court ordered? How is this verified? c. How much is paid, how often paid, and how was this verified?
14. Medical Deductions: a. Document who has the expense. Are they elderly or disabled? b. Is the expense reimbursable by Medicare or private health insurance? c. Indicate 314 on file and what expenses are being allowed, the amount of the expense, and whether it is a one-time expense, averaged or prorated over certification period. d. Document any expenses not allowed. e. Indicate if the standard deduction is being used or if actual expenses are being used.
15. Medical Insurance: (N/A)
16. Forms: No longer necessary to mark.
17. Other services and Referrals a. Narrate what things were marked on the EA-221A and what referrals were made. b. SDCareerLink - inform customers of program information and provide brochure, rack card, or flyer if needed. c. How EBT safe guards were explained to customer d. Document that voter registration was discussed and customer chose to complete or not complete form. 18. Application Action/Other comments: a. Document what verifications are pending to determine eligibility.