Calculation Of Concurrent Payment Spreadsheet Template - Individual With Earned And Unearned Income

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CALCULATION OF CONCURRENT PAYMENT AMOUNT
INDIVIDUAL WITH EARNED and UNEARNED INCOME
For Month: ___
_______ Year: _____
________
SSDI TEST TO DETERMINE SGA
___$
__ EARNED GROSS INCOME
_- $
__ DEDUCT WORK INCENTIVES (TWP)
___$
_ _ AMOUNT OF COUNTABLE INCOME TO DETERMINE SGA
1. __ $
___ UNEARNED INCOME
2. _- $
20.00_ GENERAL INCOME EXCLUSION
3. __ $
___ COUNTABLE UNEARNED INCOME
4. __$
___ EARNED GROSS INCOME
5. _--___________ STUDENT EARNED INCOME EXCLUSION
6. _- $
65.00__ EARNED INCOME EXCULSION ($85 if no SSDI check)
7. _--___________ DEDUCT IMPAIRMENT-RELATED WORK EXPENSES
8. __$
___ AMOUNT
9. _______/2 ____ DIVIDE AMOUNT BY 2
10. __$__
__ COUNTABLE EARNED INCOME
11. __$
_ _ COUNTABLE UNEARNED INCOME (LINE #3)
12. _+$_
___ COUNTABLE EARNED INCOME (LINE #10)
13. __$
__ TOTAL COUNTABLE INCOME
14. _--___________ DEDUCT PLAN FOR ACHIEVING SELF-SUPPORT
OR BLIND WORK EXPENSES
15. __ $
__ ADJUSTED TOTAL COUNTABLE INCOME
16. __$
___ FEDERAL BENEFIT RATE
17. _--$
__ _ ADJUSTED TOTAL COUNTABLE INCOME (LINE #15)
18. __$
___ ADJUSTED SSI PAYMENT
19. __ $
___ UNEARNED GROSS INCOME (LINE # 1)
20. _ _$
___ EARNED GROSS INCOME (LINE # 4)
21. + _$__ _
___ ADJUSTED SSI PAYMENT (LINE # 18)
22. __ $
___ TOTAL GROSS MONTHLY INCOME
23. __--__________ DEDUCT COST OF ALL WORK INCENTIVE (S) CLAIMED
(TOTAL OF LINES # 7 AND #14)
___$
_____ TOTAL ADJUSTED GROSS MONTHLY INCOME
Developed by Mike Walling.

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