TN 14 (02-10)

SI 01150.204 Documenting the Decision with Agreement to Sell Property (Form SSA-8060-U3)

A. Procedure for field office personnel to document the individual’s decision

The following instructions apply in both initial claims and posteligibility situations.

1. Conditional benefits declined

Obtain the individual's refusal in writing either with a statement signed or on a DROC. If the individual refuses to sign the statement, document the file to that effect.

If the individual's liquid resources exceed the statutory limits, do not document the explanation or the refusal of conditional benefits.

2. Conditional benefits accepted

If conditional benefits are accepted take the following steps:

  1. Complete Form SSA-8060-U3 (Agreement to Sell Property) per SI 01150.204B (in this section).

  2. Obtain signature(s) on Form SSA-8060-U3 at the time you complete the form or once you know that the individual meets all but the resource requirements for eligibility (including disability or blindness).

  3. Do not defer nondisability development. If such development reveals ineligibility for any reason other than excess nonliquid resources, recall the disability folder from the DDS and input the denial code for the other reason.

  4. Keep the record in payment status H80 (initial claims) or N04 (posteligibility) until acceptance of the SSA-8060-U3. At that time:

    • change payment status to CO1 effective with the first day of the following month; and

    • make appropriate input to the resources field (“other agreement to dispose”) per SM 01005.205 or SM 01305.400.

  5. Fax all documents related to conditional benefits into the Electronic Folder or NDRED.

  6. Tell the individual about the:

    • requirement to make continuing reasonable efforts to sell, including not refusing any reasonable offer to buy;

    • types of evidence we will request. For a list of types of evidence see SI 01150.205B.1.); and

    • periodic follow-up contacts.

  7. At the appropriate time issue the proper notice per SI 01150.210A.3. to inform the individual that SSA accepts the agreement and that the conditional benefits period is beginning.

B. Procedure for completing the required form

The front of Form SSA-8060-U3 specifies the conditions for payment and documents the individual's understanding and agreement to the conditions. Ask the individual to review the back of the form, which contains additional information about conditional benefits.

1. Completion of the form

Fill in the following:

  1. Identifying Information - Enter the name(s) and SSN(s) of the individual or couple, and the name of a spouse or parent whose resources are material to SSI eligibility.

  2. Describe each property to be sold.

  3. Names(s) of Owner(s) - List everyone who has an ownership interest.

  4. Nature and Percentage of Ownership - Enter the type and percentage of ownership held by each owner. For a discussion on the types of ownership go to SI 01110.500.

  5. Estimated Current Market Value - Enter the estimated CMV of individual's or deemor's ownership interest.

  6. Amount Owed on Resource - Enter any encumbrances that affect the net proceeds of the sale.

  7. Estimated Net Sale Proceeds

    To estimate net sale proceeds make the following calculations:

    • Estimate expenses in connection with the sale if it is reasonable to do so;

    • Add the estimated expenses to the encumbrance(s) listed under SI 01150.204B.1.f. (in this section);

    • Subtract the total from the estimated CMV in SI 01150.204B.1.e. (in this section); and

    • Enter the result as estimated proceeds.

Acquire signatures on Form SSA-8060-U3

Ensure that the individual or couple requesting conditional benefits signs the agreement unless there is a legal guardian, in which case the guardian must sign.

If the owner of the resources to be sold is a deemor (i.e., parent, spouse, essential person, or sponsor), make sure the deemor also signs the agreement.

2. Electronic documentation instructions

To use electronic storage:

  • Fax paper form SSA-8060 U3 into the appropriate electronic folder; and