Effective Dates: 09/18/2025 - Present Previous | Next

TN 13 (09-25)

SI 00605.025 Completing Part 4 of the SSA-8001-BK -- Income

A. Procedure - Question 30 -Income

Complete number 30 as directed on the form. For MSSICS applications, the Income Selection page (MS 08114.003) records the type of income received. After completing the Income Selection page, the system displays the appropriate income detail screens necessary to complete the application.

See SI 00605.025A.1 through SI 00605.025A.6.

REMINDER: Ask the claimant to report any income received or expected to be received beginning with the first moment of the reference date month.

If you need additional space, use “Remarks.”

1. Person Receiving Income

Identify the recipient of the income.

2. Type of Income

Identify all income generically.

EXAMPLE: If the individual receives a pension from a former employer, enter only “private pension.” If they receive a Department of Veterans Affairs (VA) payment, and the type of VA payment is not material to eligibility, it is enough to note “VA payment.”

3. Amount

Enter total amount.

4. Frequency

Note here if expected income is a one-time payment or will continue at regular intervals. (If income is paid other than monthly, the date last paid is required for MSSICS claims.)

5. Source of Income

Use this column to identify source of income unless source is obvious from income specified in “Type of Income” column, such as VA pension.

Note here if any payment received for food or shelter is received in cash or in kind.

6. Consider Exclusions

Consider any exclusion applicable (including court ordered support paid by an ineligible spouse or parent) to the alleged income which could result in countable income low enough to permit payment. Remember that the allocation for an ineligible child reduces the amount of income available for deeming. See the guide to unearned income exclusions in SI 00830.099, and refer to SI 00820.500 - SI 00820.520 and SI 00820.102 for earned income exclusions. If necessary, provide the claimant with SSA Publication No. 05-10060 Incentives To Help You Return To Work.

B. Procedure - Question 31 – Child Support

Ask if the ineligible spouse, ineligible parent, ineligible child or eligible alien (sponsored by the ineligible spouse or parent) whose income is subject to deeming, makes support payments. See SI 01320.145 for developing the exclusion from deemed income of support payments made under a court order or enforced under Title IV-D.

This information is collected on the Income Selection page (MS08114.003) for MSSICS applications.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0500605025
SI 00605.025 - Completing Part 4 of the SSA-8001-BK -- Income - 09/18/2025
Batch run: 09/18/2025
Rev:09/18/2025