Amount of Gross Earnings from Work Before Deductions - The gross amount of earnings from work for a person in the household before deductions.
Amount of Personal Use Monthly Income for Foster Child - Amount of personal use monthly income for foster child.
Ethnic Identity of Children - Ethnic identity of children.
- Hispanic or Latino
- Not Hispanic or Latino
FDPIR Case Number for Child - Food Distribution Program on Indian Reservations (FDPIR) case number for child.
FoodShare Case Number for Child - FoodShare case number for child.
Grade - Grade of child in school.
Name of Child in School - Name of child in school (first, middle initial, last).
Name of Person in Household - Name of person in household.
No Income Selection - No income selection for a person in household.
No Social Security Number Selection - No Social Security Number selection for adult household member.
Racial Identity of Children - Children's racial identities (optional) - Choose one or more.
- American Indian or Alaska Native
- Native Hawaiian or Other Pacific Islander
Retirement, Social Security Income Amount - Pensions, retirement, Social Security income amount for a person in household.
School Name - Name of school that child attends.
Signature of Adult Household Member - Signature of adult household member.
Social Security Number of Adult Household Member - Social Security Number of adult household member.
Status of Child as Foster Child - Foster child selection for child.
Status of Child as Homeless - Status of Child as Homeless.
Status of child as migrant - Status of Child as Migrant.
Status of Child as Runaway - Status of Child as Runaway.
Timeframe for Gross Income - Period for which gross income is reported for a person in household.
W-2 Cash Benefits Case Number for Child - W-2 Cash Benefits case number for child.
Welfare, Child Support, Alimony Income Amount - Welfare, child support, alimony income amount for a person in household.