Florida Healthy Kids

Income Documentation Guidelines

INCOME TYPE
DEFINITION

ACCEPTABLE DOCUMENTATION

Earned Income

The receipt of wages, salary, commission, or profit from an individual's performance of work or services

REQUIRED ARE THE FOLLOWING:

  • Income Tax Form for most recent tax year
  • In the absence of a federal tax return, an applicant may submit:
    1. Pay stubs, or
    2. W-2, or
    3. Other documents

COMMENTS:

INCOME TYPE
DEFINITION

ACCEPTABLE DOCUMENTATION

Self Employment Income

Income received by an individual who owns a business or otherwise engages in a private enterprise is considered self-employed

REQUIRED ARE THE FOLLOWING:

  • Income Tax Form for most recent tax year
  • In the absence of a federal tax return, an applicant may submit:
    1. Business Ledger/Receipts, or
    2. W-2 forms, or
    3. Income Tax Form 1099, or
    4. Work Calendar, or
    5. Bank Deposits

COMMENTS

INCOME TYPE
DEFINITION

ACCEPTABLE DOCUMENTATION

Unearned Income

Income for which there is no performance of work or services

REQUIRED ARE:

  • Income Tax Form for most recent tax year, if applicable
  • Proof of unearned income (see rows below for types of acceptable proof)

COMMENTS

INCOME TYPE
DEFINITION

ACCEPTABLE DOCUMENTATION

Social Security Benefit (including SSDI and Death Benefits)

REQUIRED ARE:

Social Security Administration Award Letter

COMMENTS

INCOME TYPE
DEFINITION

ACCEPTABLE DOCUMENTATION

Supplemental Security Income (SSI)

REQUIRED ARE:

Social Security Administration Award Letter

COMMENTS

INCOME TYPE
DEFINITION

ACCEPTABLE DOCUMENTATION

Other

  • Unemployment benefits
  • Workers Compensation
  • Annuity, pension, retirement or disability
  • Veteran's benefits
  • Railroad retirement

REQUIRED ARE THE FOLLOWING:

  • Income Tax Form for most recent tax year, if applicable
  • In the absence of a federal tax return, an applicant may submit:
    1. Awards Letter, or
    2. Check Stub

COMMENTS

INCOME TYPE
DEFINITION

ACCEPTABLE DOCUMENTATION

Other

  • Interest Income

REQUIRED ARE THE FOLLOWING:

  • Income Tax Form for most recent tax year
  • In the absence of a federal tax return, an applicant may submit:
    1. Bank Statement

COMMENTS

INCOME TYPE
DEFINITION

ACCEPTABLE DOCUMENTATION

No income

No documentation required

COMMENTS