Quick Reference Guide Income and Assets for Financial Assessment



Similar documents
Quick Reference Guide Income and Assets for Financial Assessment

APPENDIX I: INCOME AND ASSETS

Health Savings Account. Guide for Members

2014 INCOME TAX DATA ORGANIZER PLEASE ATTACH A VOIDED CHECK TO RECEIVE YOUR REFUND

Unearned income in the month of receipt. Life Insurance Proceeds of life insurance are unearned income in the month of receipt.

Using Your Health Savings Account (HSA)

Counting Income for MAGI What Counts as Income

INCOME AND DEDUCTIBLE ITEMS, SUMMARY CHART

Health Savings Account. Guide for Members

Desk Aid 56: Income and Income Deductions

Client Tax Organizer If you have rental property or are self-employed, please request additional organizers.

Health Reimbursement Arrangement (HRA)

Tax Return Questionnaire Tax Year

3. If you received any interest from a "Seller Financed" mortgage, provide: Name and Address of Payer Social Security Number Amount

Personal Information. Name Soc. Sec. No. Date of Birth Occupation Work Phone Taxpayer: Spouse: Street Address City State Zip

Tax Return Questionnaire Tax Year

Exhibit 5-1: Income Inclusions and Exclusions

Client Tax Organizer

Please complete this Organizer before your appointment. Street Address City State ZIP Home Phone

Social Security Number: Occupation: Address: Current Address (if not listed on W2 form or 1099 Taxpayer Name: Spouse Name: form):

1040 US Tax Organizer

A guide to. Information to help you use your Health Savings Account with your health plan

Attachment A Section 8 Definition of Annual Income 24 CFR, Part 5, Subpart F (Section 5.609) Annual Income.

High Deductible Health Plan

1420 n. CLAREMONT BLVD., SUITE 101-B TEL (909) CLAREMONT, CALIFORNIA FAX (909)

LAW OFFICES OF BRADLEY J. FRIGON, LLC MEDICAID INTAKE FORM (SINGLE)

Answering Questions about Your Family s Income When Applying for Health Insurance

Flexible Spending Account (FSA)

Sandberg Tax Service, LLC 1330 Flint Meadow Dr Kaysville, UT Organizer

Denver Tax Group, LLC CHADWICK ELLIOTT 1888 Sherman Street SUITE 650 DENVER, CO (0) Organizer Mailing Slip

212.3 Allowable Deductions for Households with Aged/Disabled Members

TO: All Tribal Government Leaders and Tribally Designated Housing Entities (TDHE)

Client Tax Organizer

M. Caroline Cantrell & Associates, PC Attorney at Law

July 24, 2015 HCFA 1

Fleming, Tawfall & Company, P.C Tax Questionnaire

Health Savings Account. Guide for Employers

It is important to meet with an experienced elder law attorney who understands the Medicaid rules before making any changes to your property.

Tax Return Questionnaire Tax Year

Securely connect with your money anytime, anywhere. Log in and experience the benefits.

BOARD OF REVIEW DECLARATION OF POVERTY & REQUEST FOR TAX RELIEF APPLICATION

Determining Income Eligibility. Student Workbook

Name Phone Number Year THIS WORKSHEET IS PROVIDED FOR YOUR CONVENIENCE, TO HELP YOU ORGANIZE EXPENSES FOR THE FOLLOWING:

INVENTORY AND APPRAISEMENT OF COMMUNITY ESTATE OF THE PARTIES

Name (Last, First, Initial): Address: Address: Marital Status: Single Married Widowed Divorced

Pension. Sue Kearney. NSO Training March 2012 Orlando FL 1

FULLER LANDAU LLP. Tax Return Questionnaire Tax Year. Name and Address: Social Security Occupation Number:

PEDRICK & COMPANY, LLC 103 CENTRAL AVENUE HINESVILLE, GA Organizer

TITLE 8 SOCIAL SERVICES CHAPTER 230 MEDICAID ELIGIBILITY - FULL COVERAGE FOR PREGNANT WOMEN PART 500 INCOME AND RESOURCE STANDARDS

Application for Mississippi Medicaid Aged, Blind and Disabled Medicaid Programs

A form that will help you identify, locate, and organize the important documents your will need as a primary caregiver.

FACT SHEET. Veterans Affairs Aid and Attendance Benefits C A N H R 650 HARRISON STREET, 2ND FLOOR SAN FRANCISCO, CA 94107

CLIENT NAME: CLIENT QUESTIONNAIRE - Inventory and Appraisement. Community Estate of the Parties. Current fair market value (as of ): $

Health Savings Accounts Frequently Asked Questions (FAQs)

2011 INDIVIDUAL INCOME TAX QUESTIONNAIRE. Please explain or attach supporting documentation if you answer YES to any of the following questions.

WORKFORCE INVESTMENT ACT

Client Tax Organizer

WAGNER ACCOUNTING & TAX SERVICE, INC.

Inventory and Appraisement of [Name of Party] Community Estate of the Parties

Client Tax Organizer Worksheet

CLIENT QUESTIONNAIRE - Inventory and Appraisement. Community Estate of the Parties

PERSONAL INCOME TAX RETURN CHECKLIST 30 JUNE 2015

Tax Preparation by Robin G Wixom, LLC

What is a Health Savings Account and what do I need to know? Q. What is a Health Savings Account?

Medicaid Nursing Home Information

INVENTORY AND APPRAISEMENT., files this inventory and appraisement of all assets and COMMUNITY PROPERTY

Coverage Foreign Health MUNSU Plan GSU Plan. 100 % of eligible expenses. $2,000 per student year. Unlimited. Covered Covered by MCP Covered by MCP

What Counts as Income for Premium Tax Credits and Medicaid: Beyond the Basics

Page 1 OLSON CPAs, PLLC CERTIFIED PUBLIC ACCOUNTANTS 2015 INCOME TAX ORGANIZER ********************************************************

2013 Income Tax Organizer

Special Circumstances Appeal Form

The 2015 Self-Assessment Guide For Long Term Care Insurance

PATRICK J. RUBEY & COMPANY, LTD. CERTIFIED PUBLIC ACCOUNTANTS

Exhibit 5-2: Assets. Example Withdrawals from a Keogh Account

Flexible Spending Account Election of Reimbursement & Compensation Reduction Agreement

NEW YORK STATE DEPARTMENT OF TAXATION & FINANCE OFFICE OF REAL PROPERTY TAX SERVICES

CLIENT QUESTIONNAIRE - Inventory and Appraisement. INSTRUCTIONS: We prefer that you type up your answers separately, and just refer to the

Organizer FORREST FINANCIAL SERVICES L.L.C UNIVERSITY AVE UNIT 201 DES MOINES, IA FFS

CLIENT QUESTIONNAIRE - Inventory and Appraisement. Community Estate of the Parties

MARK S. ZUCKERBERG, P.C. ATTORNEY AT LAW

D Approved for Exemption on: D 60% of value but not less than $60,000. D Approved for Refund by Assessor: D Aooroved for Refund by Treasurer:

PRIVATE HEALTH SERVICES PLAN (PHSP)

General Information - Homestead Property Tax Credit (MI-1040CR)

Medical Savings Account contributions. Doctors, dentists, clinics, hospitals, etc. MEDICAL

The 2016 Tax Filing Season!

HEALTH SAVINGS ACCOUNT

1135 E. Route 66, Suite 108 Glendora, CA

Deferral Application for Homeowners with Limited Incomes

Gleim CPA Review Updates to Regulation 2013 Edition, 1st Printing September 2013

Collection Information Statement for Wage Earners and Self-Employed Individuals

More savings. More choices. More focus on your health.

Thank you for choosing our firm to prepare your income tax returns for tax year This letter confirms the services we will provide.

STATEMENT OF CURRENT MONTHLY INCOME AND MEANS TEST CALCULATION FOR USE IN CHAPTER 7 ONLY

TAX ACCOUNTING AUDITING PLANNING

Overview. January, 2009

BEDROCK DIVORCE ADVISORS, LLC

The FHLBI may, in its discretion, allow applicants to follow the income guidelines of other funding sources where differences exist.

Alberta Government Health Insurance Plan offers Limited Coverage.

Tax Organizer. When possible, 2012 information is included for your reference. You do not need to make any 2012 entries.

Income Tax Organizer

Transcription:

Quick Reference Guide Income and Assets for Financial Assessment November 2012 Income: Payments from any source unless specifically excluded. The following sources of income are counted for the purposes of completing the financial assessment (means test): Count: Alimony Allowances Benefits Subject to Garnishment Complaint Settlement Cooperative (Co-op) Dividends Department of Labor Employment Programs Dependency and Indemnity Compensation This benefit program pays a monthly payment to a surviving spouse, child, or parents of a deceased military service member or Veteran. Farm Income/Conservation Resource Program Payments Foreign Currency Conversion Gambling/Lottery Winnings GI Bill Gifts and Inheritance of Property or Cash (The fair market value of gifts or inherited property is countable in the year they are received) Individual Retirement Account (IRA) Distributions Interest and Dividends Life Insurance Proceeds (Death Benefit paid to Veteran or spouse) Net Profits and Depreciation from Business, Farm and Ranch, Real Estate, Partnership, and S Corporations (Depreciation is added back in as income) Other Income (Prizes/Awards, Inheritances) Payments from Stocks and Bonds, Capital Gains Pensions, Annuities, Railroad Retirement Revocable Trust Royalties (Books, Music, Art, etc.) Page 1 of 5

Settlements: o Alaska Native Claims Settlement Act (amounts exceeding $2,000 per individual per annum - including cash dividends on stock received from a Native Corporation) o American Indian Beneficiaries from trust or restricted lands (amounts exceeding $2,000 per individual per calendar year) Social Security Benefits and Death Benefit Payment (including retroactive Lump Sum Payment from previous years) Timber Sales Unemployment Compensation VA Compensation (disability) Payments received by the spouse (not the Veteran) for a serviceconnected condition(s). Value of Room and Board/Housing Allowances Wages (Employment), Salaries, Bonuses, Severance Pay, Tips, and Other Accrued Benefits, etc. Workers Compensation NOTE: The above list is not all inclusive. The following sources of income are not counted for the purposes of completing the financial assessment (means test): Do Not Count: Caregiver Payments Chore Service Payments Crime Victims Compensation Act Payments Disaster Relief Payments or Proceeds of Casualty Insurance Discharge of Indebtedness Federal Emergency Management Agency (FEMA) Disaster Insurance Payments Federal Government Sponsored Economic Stimulus Refunds Foster Care Payments Income from Domestic Volunteer Service Act Program Income Tax Refunds Loans (Reverse Mortgages) Maintenance Needs-Based Payments from Government Agency Payments for participation in a program of Rehabilitative Services Provisional Income Relocation Expenses Scholarships and Grants from school attendance Settlements: o Agent Orange o Alaska Native Claims Settlement Act (income of up to $2,000 per individual per annum - including cash dividends on stock received from a Native Corporation) o American Indian Beneficiaries from trust or restricted lands (income of up to $2,000 per individual per calendar year) VA Pension Payments Welfare, Supplemental Security Income (SSI), Compensated Work Therapy (CWT), Incentive Therapy (IT) earnings Withheld Social Security Overpayments NOTE: The above list is not all inclusive. Page 2 of 5

Assets: Items of ownership convertible into cash; total resources of a person or business, as cash, notes and accounts receivable, securities, inventories, goodwill, fixtures, machinery, or real estate. The following sources of income are counted as assets for the purpose of completing the financial assessment (means test. Count: Bank Deposits Collectibles (Art, Coins, Antiques, etc.) Energy Royalties Gas Reserves Health Savings Account Balances Inherited Property (If sold in another year other than the one it is inherited, proceeds are considered an asset) Irrevocable Trust (depending on the type) Mineral Royalties Occasional Sale of Property (If occasional sale of property is inherited, it is counted as income in the year it is received) Other property of value used for investment or pleasure (Boats, Time-Shares, Recreational Vehicles, Thoroughbred Racehorses, etc.) Real Estate (excludes primary residence) Stocks, Bonds, Individual Retirement Accounts (IRAs), Certificates of Deposit (CDs), 401(k) Do Not Count: Deferred Sale Foreclosures Installment Sale Insurance policy with cash value Motor Vehicles, Jewelry, Household Possessions (Personal) Sale of Property (Sale of Primary Residence and Family Heirlooms not used for investments) Page 3 of 5

Deductible Medical Expenses: May be used to reduce other countable income for purposes of increasing pension benefits. In order to be deducted from income, unreimbursed medical expenses must exceed 5% of the VA Maximum Annual Pension Rate for the previous year. VA National Income Threshold link: http://www.va.gov/healthbenefits/cost/income_thresholds.asp The list below shows many of the common deductible medical expenses. Note: This list is not all inclusive. Allow all expenses that are directly related to medical care. Abdominal supports Acupuncture service Ambulance hire Anesthetist Arch supports Artificial limbs and teeth Back supports Braces Cardiographs Chiropodist Chiropractor Convalescent home (for medical treatment only) Crutches Dental service, for example, cleaning, x-ray, filling teeth Dentures Dermatologist Drugs, prescription and nonprescription Gynecologist Hearing aids and batteries Home health services Hospital expenses Insulin treatment Invalid chair Lab tests Lip reading lessons designed to overcome a disability Lodging incurred in conjunction with out-oftown travel for treatment (to be determined on a facts-found basis) Medicare Premiums, Parts B & D Medical Insurance Premiums Neurologist Nursing services for medical care, including nurse s board paid by claimant Occupational therapist Ophthalmologist Optician Optometrist Oral surgery Osteopath, licensed Pediatrician Physical examinations Physician Physical therapy Podiatrist Psychiatrist Psychoanalyst Psychologist Psychotherapy Radium therapy Sacroiliac belt Seeing-Eye dog and maintenance Speech therapist Splints Surgeon Telephone/teletype special communications equipment for the deaf Transportation expenses for medical purposes (41.5 cents per mile effective Jan. 1, 2009, plus parking and tolls or actual fares for taxi, buses) Vaccines Wheelchairs Whirlpool baths for medical purposes X-rays Page 4 of 5

Examples of Medical, Funeral/Burial, and Educational Deductions 1. Processing Deduction for Medical Expenses: Situation: For income year 2010, the Veteran paid $8,000 in out-of-pocket medical expenses from January 1, 2010 to December 31, 2010. The medical expense deductible is $775 (5% of the maximum allowable pension rate for the previous year). Results: The Veteran will be able to deduct $7,225 of the $8,000 paid in medical expenses. ($775 is deducted from $8,000 to satisfy the required medical deductible, e.g., $8,000 - $775 = $7,225). 2. Processing Deduction for Funeral/Burial Expenses: Situation: The spouse died on March 1, 2010. The final funeral/burial expenses paid by the Veteran were $5,500. Results: The Veteran will be able to deduct the entire amount of $5,500 paid for funeral/burial expenses. 3. Processing Deduction for Educational Expenses (deductible for Veteran only): Situation: The Veteran paid $3,000 in educational expenses (including tuition, fees, books, and necessary materials). Results: The Veteran will be able to deduct the entire amount of $3,000 paid in educational expenses. Note: Effective January 1, 2009, the deductible transportation expense for medical purposes is 41.5 cents per mile. Prior to January 1, 2009, the deductible transportation expense was 28.5 cents per mile. Reference: The general rule set forth in Title 38 Code of Federal Regulations (38 CFR) 3.271 is that all income is countable unless specifically excluded by 38 CFR 3.272. Non-reimbursed medical, funeral/burial, and educational expenses are explained in Title 38 United States Code Service, (USCS) 1503, 38 CFR 3.272(g), 3.272(h)(1), 3.272(h)(2)(i), 3.272(i), and M21-1MR, Part V, Subpart iii, Chapter 1, Section G. For More Information: If you have additional questions, please contact the Health Eligibility Center (HEC), Income Verification Division (IVD) at 1-800-929-VETS (8387). Page 5 of 5