1) Household Information
# of household Members With Income		# of household Members Without Income		Total # of Household Members
	+		=	0

2) Household Income
LEGEND: 1 = Annual | 2 = Monthly | 3 = 2x Month | 4 = Bi-Weekly | 5 = Weekly
Earnings From Work Before Deductions	Welfare, Child Support, Alimony	Pensions, Retirement, Social Security, SSI, VA Benefits	All Other Income