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ISSUE DATE: 12/2016

Verify self-employment income as a condition of eligibility. The client may use business records or the Self-Employment Report Form (DHS-3336) (PDF) as monthly proof of self-employment income and expenses. Use tax forms or tax records as verification for Taxable Income method. See 0017.15.33.03 (Self-Employment, Convert Inc. to Monthly Amt).

Business records include:

Copies of daily, weekly, or monthly ledgers.


Itemized receipts.

Purchase orders.

Copies of customer receipts.

Transportation logs.

Cancelled checks.

Copy of business checking account statement.

County agency forms.

Records from the Small Business Administration (SBA).

Records from the Farmers Home Administration (FHA).

Records from the Production Credit Association (PCA).

Statements from the client's customers.

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