Fill in the following:
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a.
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.
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b.
Describe each property to be sold.
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c.
Names(s) of Owner(s) - List everyone who has an ownership interest.
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d.
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.
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e.
Estimated Current Market Value - Enter the estimated CMV of individual's or deemor's
ownership interest.
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f.
Amount Owed on Resource - Enter any encumbrances that affect the net proceeds of the
sale.
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g.
Estimated Net Sale Proceeds
To estimate net sale proceeds make the following calculations:
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•
Estimate expenses in connection with the sale if it is reasonable to do so;
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•
Add the estimated expenses to the encumbrance(s) listed under SI 01150.204B.1.f. (in this section);
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•
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.