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<br />Page | 29 <br />(GA)/Aged, Blind or Disabled Cash Program (ABD) must not have their cash benefits count towards <br />income. <br />4.6 Homelessness Prevention Documentation of Income Eligibility <br />Lead/subgrantees must verify and document income eligibility prior to program entry. <br /> <br />CHG Verification of Household Eligibility and Income Recertification Form, all allowable income <br />documentation, and the CHG Income Eligibility Worksheet (or equivalent) must be kept in the client <br />file. Documentation must be dated within 30 days. <br /> <br />Adult household members that have no income are required to complete a CHG Self-Declaration Form. <br /> Annualizing Wages and Periodic Payments <br />Use the CHG Income Eligibility Worksheet (or equivalent) to calculate income based on hourly, weekly, <br />or monthly payment information. Add the gross amount earned in each payment period that is <br />documented and divide by the number of payment periods. This provides an average wage per <br />payment period. Depending on the schedule of payments, use the following calculations convert the <br />average wage into annual income: <br />✓ Hourly wage multiplied by hours worked per week multiplied by 52 weeks. <br />✓ Weekly wage multiplied by 52 weeks. <br />✓ Bi-weekly (every other week) wage multiplied by 26 bi-weekly periods. <br />✓ Semi-monthly wage (twice a month) multiplied by 24 semi-monthly periods. <br />✓ Monthly wage multiplied by 12 months. <br /> <br />The CHG Income Eligibility Worksheet is not required for households that have no income or receive <br />only Temporary Assistance for Needy Families (TANF) or General Assistance (GA)/Aged, Blind or <br />Disabled Cash Program (ABD). <br />4.7 Homelessness Prevention Eligibility Recertification <br />Lead/subgrantees must document recertification of household income eligibility at least every three <br />months using the CHG Verification of Household Eligibility and Income Recertification Form. <br /> Income Ineligible at Recertification <br />If households are determined income ineligible, they may remain in the program for an additional <br />three months. Case management may continue for an additional six months after the determination of <br />income ineligibility to support the household transition to self-sufficiency. <br />4.8 Landlords Applying for Homelessness Prevention Assistance on Behalf of Tenant <br />Lead/subgrantees must allow landlords to initiate a request for assistance on behalf of their tenants by <br />completing the Certification of Payment Obligation Form. Eligibility is based on tenant eligibility. At <br />minimum, a reasonable attempt to contact the tenant must be made by the lead/subgrantee using the <br />information provided from the landlord. The lead/subgrantee must create a process for what is <br />reasonable based on the agency and staffing capacity. <br />