Fill in the following:
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.
Describe each property to be sold.
Names(s) of Owner(s) - List everyone who has an ownership interest.
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.
Estimated Current Market Value - Enter the estimated CMV of individual's or deemor's
Amount Owed on Resource - Enter any encumbrances that affect the net proceeds of the
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);
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.