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- Statement of Household Expenses and Contributions - SSA-8011
Write "0" under amount if your household has not spent any money for one of the expenses 1 Food (Do not include food bought with food stamps ) $ 2 Rent or Mortgage Payment $ 3 Property Insurance (if not included in mortgage payment and if required by mortgage holder) $ 4 Real property taxes (if not included in mortgage payment)
- SSA-8011-F3 - REGINFO. GOV
Answer the questions where we have checked the block Then sign the form and return to Social Security For household expenses that change from month to month, show the average monthly amount of money your household has spent per month for the period through
- SSA-8011 Statement of Household Expense and Contributions
OMB 0960-0835 reference document for SSA-8011 Statement of Household Expense and Contributions
- SSA - POMS: SI 00835. 625 - SSA-8011 — Statement of Household Expenses . . .
For living arrangement (LA) periods effective 09 30 2024 or later, use form SSA-8012 to document a claimant or recipient’s statement about household expenses and contributions This form no longer requires a signature
- Form SSA-8011-F3 (08-2017) UF Page 1 of 3 SOCIAL SECURITY . . .
Answer the questions where we have checked the block Then sign the form and return to Social Security PART I - MONTHLY HOUSEHOLD EXPENSES For household e penses that change from month to month, show the average monthly amount of money your household has spent per month for the period through
- SSA - POMS: SI 00835. 625 - SSA-8011 mdash; Statement of Household . . .
For living arrangement (LA) periods effective 09 30 2024 or later, use form SSA-8012 to document a claimant or recipient’s statement about household expenses and contributions This form no longer requires a signature
- Printing L:\MHFORMS\S8011. FRP - REGINFO. GOV
Answer the questions where we have checked the block Then sign the form and return to Social Security For household expenses that change from month to month, show the average monthly amount of money your household has spent per month for the period through
- Printing L:\BRIAN~1\REVISI~1\SSA-80~1\S8011. FRP - REGINFO. GOV
Answer the questions where we have checked the block Then sign the form and return to Social Security For household expenses that change from month to month, show the average monthly amount of money your household has spent per month for the period through
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