| Household Size | Income | |
|---|---|---|
| Free | RP | |
| Weekly | Every 2 Weeks | Twice per Month | Monthly | Annual | Total | |
|---|---|---|---|---|---|---|
| Enter Income Amount(s): | ||||||
| Total Calculated weekly by hour from below (Optional) | ||||||
| Calculated average weekly from below (Optional) | ||||||
| Calculated 2 weeks by hour from below (Optional) | ||||||
| From Self Employment Income box below | ||||||
You have selected Annual or more than one frequency. Please enter an annual amount or enter at least two income frequencies.
| Self Employment Income | |
|---|---|
| Business Income or (Loss) Schedule 1 Part 1, LINE 3 | |
| Capital Gain or (Loss) Form 1040 or 1040-SR, LINE 7 | |
| Other Gains or (Losses) Schedule 1 Part 1, LINE 4 | |
| Rental real estate, royalties partnerships, S corporations, trusts, etc. Schedule 1 Part 1, LINE 5 | |
| Farm Income or (Loss) Schedule 1 Part 1, Line 6 | |
| Total | |
| Calculate Weekly Income by Hours (Optional) | ||
|---|---|---|
| Hourly Pay X | Hours Worked = | Weekly Amount |
| 1. | ||
| Calculate Every 2 Weeks Income by Hours(Optional) | ||
|---|---|---|
| Hourly Pay X | Hours Worked in 2 weeks = | 2 Weeks Amount |
| 1. | ||
| Calculate Average Weekly Income (Optional) | |
|---|---|
| Week 1 amount | |
| Week 2 amount | |
| Week 3 amount | |
| Week 4 amount | |
| Average weekly income | |
| Household Size | ||
|---|---|---|
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