ALL OTHER HOUSEHOLD MEMBERS Sample Clauses

ALL OTHER HOUSEHOLD MEMBERS. Enter Gross Income Under Each Income Type each Household Member Receives and "How Often" the Income is Received by using the following Income Codes: W=Weekly, E=Every 2 Weeks, T=Twice a Month, M=Monthly, Y=Yearly. If No Income, You MUST Mark the "No Income box." DO NOT Leave Blank. Adult's Full Name (Do not repeat names from Section A) MARK "X" If No Income Gross Earnings from Work Paid Before Deductions, Include How All jobs Often? Indicate Pay from Pensions, Retirement, Social Security, VA benefits Income Paid Source? How Often? Welfare Benefits, Child Support, Alimony Payments Income Source? Paid How Often? Any Other Income, Including Temporary Income Income Source? Paid How Often? Enter Benefit Type: CalFresh, CalWORKS, Kin‐GAP, FDPIR Enter Benefit Case Number Xxxxxxx, Xxxxxx $ 199.98 W $ 141.65 Pension Y $ 99.99 Child Support M $ 550.00 Rental Income M ① $ $ $ $ ② $ $ $ $ ③ $ $ $ $ ④ $ $ $ $ ⑤ $ $ $ $