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Official source

DEPARTMENT FOR AGING AND REHABILITATIVE SERVICES AUXILIARY GRANT PROGRAM NON-SSI INCOME SOURCES 07/19 CHAPTER I, PAGE 15

• Records of the agency through which the payments are made; • Official documents in the individual’s possession (e.g., legal documents) that establish the amount and frequency of the support; • A statement from the source of the payment containing the amount and frequency of the alimony or spousal support. 11.2.1. Verification Not Available If none of the above verifications is available, accept the individual’s signed allegation over a penalty clause. 12. Annuity Payments Unearned Income An annuity is a sum paid yearly or at other specific times in return for the payment of a fixed sum. Annuities may be purchased by an individual or by an employer. An annuity is a contract reflecting payment to an insurance company, bank or other registered or licensed entity by which one receives fixed, non variable payments on an investment for a lifetime or a specified number of years. 12.1. Income Treatment See Chapter I – 56, Retirement Funds to determine the countability of annuities. 13. Assistance Based On Need (ABON) Excluded Income ABON is assistance: • Provided under a program which uses income as a factor of eligibility; and • Funded wholly by a State (including the District of Columbia, Indian tribes and the Northern Mariana Islands), a political subdivision of a State, or a combination of such jurisdictions o Example - General Relief Note: If a program uses income to determine payment amount but not eligibility, it is not ABON (e.g., some crime victims’ compensation programs). 13.1. Income Treatment Assistance based on need is totally excluded from income.

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Page 24

Official source

DEPARTMENT FOR AGING AND REHABILITATIVE SERVICES AUXILIARY GRANT PROGRAM NON-SSI INCOME SOURCES 07/19 CHAPTER I, PAGE 15

• Records of the agency through which the payments are made; • Official documents in the individual’s possession (e.g., legal documents) that establish the amount and frequency of the support; • A statement from the source of the payment containing the amount and frequency of the alimony or spousal support. 11.2.1. Verification Not Available If none of the above verifications is available, accept the individual’s signed allegation over a penalty clause. 12. Annuity Payments Unearned Income An annuity is a sum paid yearly or at other specific times in return for the payment of a fixed sum. Annuities may be purchased by an individual or by an employer. An annuity is a contract reflecting payment to an insurance company, bank or other registered or licensed entity by which one receives fixed, non variable payments on an investment for a lifetime or a specified number of years. 12.1. Income Treatment See Chapter I – 56, Retirement Funds to determine the countability of annuities. 13. Assistance Based On Need (ABON) Excluded Income ABON is assistance: • Provided under a program which uses income as a factor of eligibility; and • Funded wholly by a State (including the District of Columbia, Indian tribes and the Northern Mariana Islands), a political subdivision of a State, or a combination of such jurisdictions o Example - General Relief Note: If a program uses income to determine payment amount but not eligibility, it is not ABON (e.g., some crime victims’ compensation programs). 13.1. Income Treatment Assistance based on need is totally excluded from income.