Income Documentation Requirements
Sources of Income and Allowable Documentation
The chart below contains examples of required income documents. You must include documentation of income from all
sources for ALL people living in the household who are 18 years or older. Income documents must be current and must
include gross income (before deductions) and be dated within the LAST 12 MONTHS unless otherwise specified.
All sources of income must have identifying information matching the recipient to the household, such as the recipient's name and/or address.
All sources of income must have identifying information matching the recipient to the household, such as the recipient's name and/or address.
Proof of Public Assistance Program Eligibility
Non-Renewing Programs: Please submit proof eligibility or enrollment in the following programs for the LAST 24 MONTHS:
Disadvantaged Communities—Single Family Solar Homes (DAC-SASH)
- Letter or proof of program enrollment/participation
Energy Savings Assistance Program (ESA)
- Letter or proof of program enrollment/participation
Self-Generation Incentive Program (SGIP)
- Letter or proof of program enrollment/participation
Single Family Affordable Solar Homes (SASH)
- Letter or proof of program enrollment/participation
Weatherization Assistance Program (WAP)
- Letter or proof of program enrollment/participation
Proof of Public Assistance Program Eligibility
Yearly Renewing Programs: Please submit proof eligibility or enrollment in the following programs for the LAST 12 MONTHS:
CalFresh/SNAP (Supplemental Nutrition Assistance Program)
- Award letter or Notice of Action letter
- Screenshot/print screen from issuing agency
- Screenshot/print screen from website (CA.gov) showing current participation
CALWORKS TANF (Temporary Assistance for Needy Families)
- Award letter or Notice of Action letter
- Bank statement with direct deposit source (gross amount) attached
- Affidavit of income
- Screenshot/print screen agency
- Copy of uncashed check
Tribal TANF (Temporary Assistance for Needy Families)
- Award letter or Notice of Action letter
- Bank statement with direct deposit source (gross amount)
- Screenshot/print screen from issuing agency
Tribal Head start
- Award setter or Notice of Action letter
Bureau of Indian Affairs
- Award letter or Notice of Action letter
- Bank statement with direct deposit source (gross amount)
- Screenshot/print screen from issuing agency
- Copy of uncashed check
Medi-Cal
- 3rd party Medi-CAL card (LA Care, IEHP, HealthNet, etc.)
- Adoption Assistance or Foster Care award letter
- Award letter or Notice of Action letter
- Issuance History Printout Stamped by the County
- 1095-B from the Department of Health Care Services
- Benefits ID card (issued within 12 months)
- Screenshot/print screen from issuing agency
- Screenshot/print screen from website
Medi-Cal for Families
- Award letter or Notice of Action letter
- Current (within 60 days) premium statement (not past due)
- Screenshot/print screen from issuing agency
- Screenshot/print screen from website
- Tax Form 1095-B
Medi-Cal/Medi-Caid Assistance
- Award letter/Notice of Action letter
- Benefits ID card with a valid issue date within the past 12 months of enrollment date
- Tax Form 1095-B
SSI (Supplemental Security Income)
- Award letter or Notice of Action letter
- Bank statement with direct deposit source (gross amount)
- Screenshot/print screen from issuing agency
- Copy of uncashed check
- Caseworker may fax information to Program Representative
WIC (Women, Infants and Children)
- Award letter or Notice of Action letter
- WIC phone app screenshot/print screen
LIHEAP (Low Income Home Energy Assistance Program)
- Proof of LIHEAP benefit on utility bill
- Eligibility notice from LIHEAP Service Provider
All Other Forms of Income
Please submit proof any of the following sources of income for the LAST 12 MONTHS:
Pension/401K(IRA) disbursement
- Bank statement with direct deposit source (gross amount)
- Check or check stubs
- Award letter/Notice of Action letter
- Federal income tax filing with W2s and/or 1099s attached
- Form 1099
Disability or unemployment
- Award letter/Notice of Action letter
- Copy of Check or check stubs
- Screenshot/print screen from issuing agency with linking document(s)
- Federal income tax filing with W2s and/or 1099s attached
Foster Care/VA Benefits/Workers Comp.
- Award letter/Notice of Action letter
- Copy of Check or check stubs
- Screenshot/print screen from issuing agency with linking document(s)
- Federal income tax filing with W2s and/or 1099s attached
SSA (Social Security)
- Bank statement with direct deposit source (gross amount)
- Copy of Uncashed check(s)
- Screenshot/print screen from issuing agency showing current participation
- Award letter/Notice of Action letter
- Federal income tax filing with W2s and/or 1099s attached
- Form 1099
Capital or Other Gains
- Federal income tax filing with W2s and/or 1099s attached
Self-employment/Business Earnings
- Federal income tax filing with Schedule C attached
- Affidavit of income
Monetary gift(s)
- Bank statement with direct deposit source (gross amount)
- Affidavit of income
Alimony or child support
- Most Recent Court Documents
- Copy of Check or check stubs
- Affidavit of income
- Notarized document
- Bank statement with direct deposit source (gross amount)
Interest/Dividends
- Annual investment statement
- Complete tax return and/or 1099
Insurance/Legal Settlements/Annuities
- Bank statement with direct deposit source (gross amount)
- Settlement Document
- Annuity Letter
- Copy of Check Stub
Wages/Salaries/Commissions
- Federal income tax filing with W2s and/or 1099s attached
- Payroll check stub(s) or deposit notice(s)
- Affidavit from the employer (for cash wages only and only for one employer)
School Grants/Scholarships/Student Aid/Foreign Exchange
- Cancelled check(s)
- Award letter/Notice of Action letter
Per capita Tribal Payments
- Copy of check or bank statement showing direct deposit
Proceeds made from Loans
- Signed and dated letter
Documentation of Assets
- Signed self-certification statement stating how you support your household and certifying that you meet the current income guidelines established for participation. (i.e. money in bank accounts)
Documentation of Housing Subsidies
- Annual or recertification determination letter
Documentation of transferred funds
- Bank statement or receipt showing transaction
Documentation of Asset Liquidation
- Bill of Sale, signed payment receipt, or signed and dated statement