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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
IN-HOME SUPPORTIVE SERVICES (IHSS)
SPONSOR TO ALIEN DEEMING WORKSHEET
(20 CFR 416.1166a)
INCOME
1. Enter Gross Income (earned and unearned) of the sponsor(s) and the
sponsor's spouse.
2. Enter Allocation for Sponsor(s).
Each sponsor's allocation is equal to
the federal SSI rate [not including the SSP rate] for an individual ($545
as of January 2002). If the co-sponsors are married, the total
allocation is two times the federal SSI rate.
3. Subtract the Allocation for Sponsor(s) from Gross Income and enter
result.
4. Enter Allocation for Dependent(s) of the sponsor (other than the alien-
applicant). Deduction of one-half of the federal SSI only rate for an
individual for each dependent (a spouse who is not a co-sponsor
receives the dependent allocation).
5. Subtract Allocation for Dependent(s) from Line 3 and enter result
(zero, if a negative number). The amount is deemed to the immigrant.
Enter on line A.1.a - c. of the IHSS Income Eligibility worksheet.
$ _________________
- $ ________________
= $ ________________
- $ ________________
= $ ________________
RESOURCES
1. Enter Total Countable Resources of the sponsor(s) and sponsor's
spouse (if living together).
2. Enter Allocation for Sponsor(s). Each sponsor's allocation is equal to
the SSI resource limit of $2,000 for an individual, or $3,000 for a couple
when both members of the couple are living together and one member
is not a co-sponsor.
If both members of the couple are co-sponsors,
the allocation is twice the individual resource limit.
3. Subtract Allocation for Sponsor(s) from Total Countable Resources
and enter result (zero, if a negative number). This amount is deemed
to the immigrant and should be added to the recipient's own resources
to determine eligibility.
$ ________________
- $ ________________
= $ ________________
SUPERVISOR’S SIGNATURE DATE WORKER DATE
SOC 811 (4/02)
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