Food Stamp Budget Work Sheet For Households With Elderly (60 Or Over) Or Disabled Member - State Of Alaska Department Of Health And Social Services Page 2

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FOOD STAMP BUDGET WORK SHEET, page 2
For Households with Elderly (60 or Over) or Disabled Member
Check Net Income
R.
Compare MONTHLY NET INCOME (Q) to chart.
If prospective net income exceeds the amount on the chart, the household is ineligible.
Household Size
1
2
3
4
5
6
7
8
+1
Maximum Net Income
$1,165
$1,577
$2,402
$2,815
$3,227
$3,640
$4,052
$413
$1,990
PART II: Find food Stamp Benefit Amount
S.
Find MAXIMUM FOOD STAMP ALLOTMENT from chart below:
(S)
HH Size
1
2
3
4
5
6
7
8
+1
$797
$1,434
Maximum
Urban
$239
$438
$627
$946
$1,135
$1,255
$179
Rural I
FS
$304
$559
$800
$1,016
$1,207
$1,448
$1,600
$1,829
$229
Allotment
Rural II
$371
$680
$974
$1,237
$1,469
$1,762
$1,948
$2,226
$278
T.
Multiply the MONTHLY NET INCOME (Q) by 0.3 (Q x 0.3) to find the
ADJUSTED FOOD STAMP INCOME (T)
–
(T)
U.
Subtract the ADJUSTED FOOD STAMP INCOME (T) from the
MAXIMUM FOOD STAMP ALLOTMENT (S) (S – T)
=
(U)
V.
Round down to the next whole dollar to find the
MONTHLY FOOD STAMP BENEFIT AMOUNT (V)
(V)
W.
If there are 3 or more household members, and (V) is $1, $3, or $5,
Round up to $2, $4, or $6
(W)
X.
If there are 1 or 2 household members, and (V) is less than the minimum
benefit, round up to the minimum benefit. If the ADJUSTED FOOD
(X)
STAMP INCOME (T) is greater than the MAXIMUM FOOD STAMP
ALLOTMENT (S), the allotment is the minimum benefit.
Y.
MONTHLY FOOD STAMP BENEFIT AMOUNT:
Calculate Benefit Amt
(Enter (V), or (W), or (X) if they apply)
(Y)
PART III: Pro-rate the First Month Food Stamp Benefit
1)
Number of days in month + 1
(1)
2)
Subtract the day of the month the household applied
–
(2)
3)
Subtotal (1 – 2)
=
(3)
÷
4)
(4)
Divide by number of days in month (28 or 29 or 30 or 31)
Subtotal (3 ÷ 4)
5)
(5)
=
6)
Multiply by the MONTHLY FOOD STAMP BENEFIT AMOUNT (5 x Y)
x
(6)
7)
Unrounded food stamp benefit amount
=
(7)
8)
Round down to the next whole dollar to find the FOOD STAMP BENEFIT
AMOUNT. If rounded amount is less than $10, household gets no allotment for
first month.)
(8)
Calculate Pro-rated Amt
Reset Form
Automated FSP 74 (06-3828) (Effective 10/2012 through 9/2013)
Alaska FS Manual Addendum 7
Page 2

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