§ 3042.65. Verification of income.
(a) Acceptable verification of earned income from employment includes one of the following:
(1) Pay stubs reflecting earnings for 4 weeks in the most recent 6-week period, the Department’s employment verification form reflecting actual or anticipated earnings, the Internal Revenue Service form used for reporting tips, an employer statement of anticipated earnings and hours, or other document that establishes the parent’s or caretaker’s earnings or anticipated earnings from employment.
(2) Another document that establishes income from work.
(3) The Department’s cash verification form.
(4) A collateral contact as specified in § 3042.62 (relating to collateral contact).
(5) A written self-declaration by the parent or caretaker as specified in § 3042.64 (relating to self-declaration).
(b) Acceptable verification of income from self-employment includes:
(1) Tax returns, including schedules related to self-employment, filed for the preceding Federal tax year and which document profit for that year.
(2) The Department’s self-employment verification form that includes a statement of gross earnings, minus allowable cost of doing business, and that shows a profit.
(c) Acceptable verification of unearned income includes one of the following:
(1) A copy of a current benefit check, an award letter that designates the amount of a grant or benefit, such as a letter from the Social Security Administration stating the amount of the Social Security benefit, a bank statement, a court order, or other document or database report that establishes the amount of unearned income.
(2) A collateral contact as specified in § 3042.62.
(3) A written self-declaration by the parent or caretaker as specified in § 3042.64.
(d) Acceptable verification of the amount of support received or paid by the family includes one of the following:
(1) Information from the Pennsylvania Child Support Enforcement System.
(2) Information from a domestic relations office.
(3) Court order.
(4) Pay stub.
(5) Written statement by the noncustodial parent or the noncustodial parent’s legal representative.
(6) A copy of a current benefit check that designates the amount of support.
(7) Collateral contact as specified in § 3042.62.
(8) A written self-declaration by the parent or caretaker as specified in § 3042.64.
Cross References This section cited in 55 Pa. Code § 3042.68 (relating to verification of circumstances relating to a decrease in copayment); 55 Pa. Code § 3042.145 (relating to domestic and other violence); and 55 Pa. Code § 3042.146 (relating to homelessness).
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