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Other Sources of Countable Income: ________ Public assistance ________ Disability/Unemployment ________ Workers Compensation ________ Spousal Support ________ Child Support ________ Survivor benefits ________ Retirement benefits ________ Dividends/Interest ________ Rental Income ________ Foster care grant ________ Financial assistance for child ________ Veterans pension ________ Annuity/Pension ________ Inheritance ________ Housing included in pay ________ Auto included in pay ________ Student loan living expenses ________ Insurance settlements ________ Net gain from property ________ Other income ________ Subtotal ________ GMI from column 1 ________ Total Countable Income California Department of Education July 2012     =>?ijno1 4 9 < Y _ c e p q ǼDz}ujhMh[SOJQJh[SOJQJh-CJOJQJhy5CJOJQJhYCJOJQJhYCJH*OJQJhyCJH*OJQJhyCJOJQJh&h[SOJQJh&h[SCJOJQJh&h[S5OJQJh3g CJOJQJh3g h3g >*hI2h3g >* h3g >*%>?HT]i  !$Ifgd&$a$ #gd3g ijklmnH::::  !$Ifgd&kd$$Ifl\ )8"""" t0644 lap(yt&no, p q HCCCCA & Fkd$$Ifl\ )8"""" t0644 lap(yt& , - 2 d  ? @ A P R T k l m p  Ƚsh^hyCJOJQJh)hyOJQJh[ShyCJOJQJaJh1U]hyCJOJQJh[SCJOJQJhMhyCJOJQJaJhyCJOJQJhy5CJOJQJhy5CJOJQJh[ShyOJQJh[Shy5OJQJhMhyOJQJhMh[SOJQJhMh OJQJ$q , - @ A l m   ] ` 0^`0 0^`0 ^` -^`-^ & F hh^hgd[S    ` e '*NOcdenorŶܶܶ~shhy5CJOJQJhPhyOJQJh[ShyOJQJ\h)hyOJQJhyCJOJQJh[ShyOJQJh[Shy5OJQJh[ShyCJOJQJaJh1U]hyCJOJQJh[SCJOJQJhy5CJOJQJhMhyCJOJQJaJhyCJOJQJ( &'dest#>_}(gdMgd/M^.rst#,=>G_ht|} ƹư}t}ld\ldldldldldldldldldh/MOJQJhYOJQJhpOJQJhM5OJQJhY5OJQJh/Mh/MCJaJhMh/MCJaJ&hMh/M6CJOJQJ]^JaJh/M5OJQJh1U]hyCJOJQJhy5CJOJQJhYhy5CJOJQJaJh1U]hyCJOJQJ\^Jhy5CJOJQJ\^J$3[u'G]o $(a$gd3g $(a$gd/M<gdM(gdM!3<PZ[du~&'0FGP]fnox|ظh~jh~Uh3g h/MCJOJQJaJh/MCJOJQJaJh/M5OJQJha?5OJQJhMha?5OJQJh)OJQJh ha?6OJQJh1U]OJQJha?OJQJh wOJQJhYOJQJhpOJQJ0 $(a$gd3g  $ #a$gd3g h3g h/MCJOJQJaJh~h hMOJQJ^JhMhMCJaJhMhI2hM>*51h0:p3g = /!"#$Z% N 01h0:p3g = /!"#$v% P0 0$@$$If!vh#v":V l t065"p(yt&$$If!vh#v":V l t065"p(yt&^ 2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH L@L  Heading 1$$@&a$5OJQJ\^JD@D  Heading 2$@&5CJOJQJDA D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List F>@F Title$a$5>*CJ OJQJ\^J4@4 Header  !4 @4 Footer  !j#j [S Table Grid7:V0.)1.  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AcDpbT{zjf=ak('];vn~87B0lMBU::'          +* 3g ]-yn#^P'a?cC- GwKY nZ1U]^#g l;s woe|[/Mp~[S)\ (YS`8P Mv&d0I2b%B DY, @ h@UnknownG*Ax Times New Roman5Symbol3. *Cx Arial?= *Cx Courier New;WingdingsA$BCambria Math"hr&: : !24  3QHX ? nZ2!xx GIncome Calculation Worksheet - Child Development (CA Dept of Education)gThis form provides parents seeking subsidized child care with a guideline to calculate eligible income. CDE Employee Charles Vail@         Oh+'0$Xp|      HIncome Calculation Worksheet - Child Development (CA Dept of Education)hThis form provides parents seeking subsidized child care with a guideline to calculate eligible income.CDE Employee Normal.dotmCharles Vail4Microsoft Office Word@G@,@ UW@^W: ՜.+,0D hp  $CA. 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