SVFN4001 |
| No | Yes | |
SVFN4002 |
| No | Yes | |
SVFN4003 |
| No | Yes | |
SVFN4004 |
Relationship to Head of Household (en) |
| No | Yes | |
SVFN4005 |
| No | Yes | |
SVFN4006 |
Social Security Number (en) |
| No | Yes | |
SVFN4007 |
| No | Yes | |
SVFN4008 |
| No | Yes | |
SVFN4009 |
| No | Yes | |
SVFN4010 |
Child Support Enforcement (en) |
| No | Yes | |
SVFN4011 |
Invalid Resource Transfer (en) |
| No | Yes | |
SVFN4012 |
Intentional Program Violation (en) |
| No | Yes | |
SVFN4013 |
| No | Yes | |
SVFN4014 |
Total Unearned Income (en) |
| No | Yes | |
SVFN4015 |
| No | Yes | |
SVFN4016 |
Total Gross Countable Income (en) |
| No | Yes | |
SVFN4017 |
| No | Yes | |
SVFN4018 |
Total Household Deductions (en) |
| No | Yes | |
SVFN4019 |
| No | Yes | |
SVFN4020 |
| No | Yes | |
SVFN4022 |
| No | Yes | |
SVFN4023 |
Initial Household Benefit Amount (en) |
| No | Yes | |
SVFN4024 |
Maximum Monthly allotment (en) |
| No | Yes | |
SVFN4025 |
Monthly Household Benefit Amount (en) |
| No | Yes | |
SVFN4026 |
Net Income Multiplied by 30% (en) |
| No | Yes | |
SVFN4027 |
| No | Yes | |
SVFN4028 |
| No | Yes | |
SVFN4029 |
| No | Yes | |
SVFN4030 |
| No | Yes | |
SVFN4031 |
Net Self-Employment Income (en) |
| No | Yes | |
SVFN4033 |
| No | Yes | |
SVFN4034 |
Other Unearned Income (en) |
| No | Yes | |
SVFN4035 |
Total Countable Resources (en) |
| No | Yes | |
SVFN4036 |
Resource Limit For Household Size (en) |
| No | Yes | |
SVFN4037 |
| No | Yes | |
SVFN4038 |
| No | Yes | |
SVFN4039 |
| No | Yes | |
SVFN4040 |
| No | Yes | |
SVFN4041 |
| No | Yes | |
SVFN4042 |
| No | Yes | |
SVFN4043 |
| No | Yes | |
SVFN4044 |
| No | Yes | |
SVFN4045 |
| No | Yes | |
SVFN4046 |
Benefit Reduction Applied (en) |
| No | Yes | |
SVFN4047 |
| No | Yes | |
SVFN4048 |
| No | Yes | |
SVFN4049 |
| No | Yes | |
SVFN4050 |
Total Deemable Resources (en) |
| No | Yes | |
SVFN4051 |
| No | Yes | |
SVFN4052 |
| No | Yes | |
SVFN4053 |
Child Support Payments (en) |
| No | Yes | |
SVFN4054 |
| No | Yes | |
SVFN4055 |
| No | Yes | |
SVFN4056 |
| No | Yes | |
SVFN4057 |
Earned Income Deduction (en) |
| No | Yes | |
SVFN4058 |
Self Employment Losses (en) |
| No | Yes | |
SVFN4059 |
| No | Yes | |
SVFN4060 |
| No | Yes | |
SVFN4063 |
| No | Yes | |
SVFN4064 |
| No | Yes | |
SVFN4065 |
Work Requirement - Head of Household (en) |
| No | Yes | |
SVFN4066 |
Voluntary Quit - Head of Household (en) |
| No | Yes | |
SVFN4067 |
Gross Unearned Income (en) |
| No | Yes | |
SVFN4068 |
Total Deductions for Household (en) |
| No | Yes | |
SVFN4069 |
| No | Yes | |
SVFN4070 |
| No | Yes | |
SVFN4071 |
| No | Yes | |
SVFN4072 |
| No | Yes | |
SVFN4073 |
$30 and 1/3 Disregard (en) |
| No | Yes | |
SVFN4074 |
| No | Yes | |
SVFN4075 |
| No | Yes | |
SVFN4076 |
| No | Yes | |
SVFN4080 |
| No | Yes | |
SVFN4077 |
In-kind Support(ISM) (en) |
| No | Yes | |
SVFN4078 |
Unearned Income Deductions (en) |
| No | Yes | |
SVFN4079 |
Earned Income Deductions (en) |
| No | Yes | |
SVFN4090 |
| No | Yes | |
SVFN4081 |
| No | Yes | |
SVFN4082 |
Violating Parole or Probation (en) |
| No | Yes | |
SVFN4083 |
Fraudulent Misrepresentation (en) |
| No | Yes | |
SVFN4084 |
| No | Yes | |
SVFN4085 |
| No | Yes | |
SVFN4086 |
School Attendance Non Compliance (en) |
| No | Yes | |
SVFN4087 |
Minor Parent School Attendance (en) |
| No | Yes | |
SVFN4088 |
Minor Parent Living Arrangement (en) |
| No | Yes | |
SVFN4089 |
| No | Yes | |
SVFN4091 |
Sale of a Controlled Substance (en) |
| No | Yes | |
SVFN4092 |
Trafficking Food Stamps (en) |
| No | Yes | |
SVFN4093 |
| No | Yes | |
SVFN4094 |
| No | Yes | |
SVFN4095 |
| No | Yes | |
SVFN4096 |
| No | Yes | |
SVFN4097 |
| No | Yes | |
SVFN4098 |
| No | Yes | |
SVFN4099 |
Disabled Adult Child (en) |
| No | Yes | |
SVFN4100 |
| No | Yes | |
SVFN4101 |
SSI Child on Aug 8 1996 (en) |
| No | Yes | |
SVFN4102 |
Adjusted Gross Income (en) |
| No | Yes | |
SVFN4103 |
| No | Yes | |
SVFN4104 |
| No | Yes | |
SVFN4105 |
| No | Yes | |
SVFN4106 |
Standard Work Allowance Deduction (en) |
| No | Yes | |
SVFN4107 |
Dependent Care Deduction (en) |
| No | Yes | |
SVFN4108 |
Other Income Deductions (en) |
| No | Yes | |
SVFN4109 |
Application During Enrollment Period (en) |
| No | Yes | |
SVFN4110 |
| No | Yes | |
SVFN4111 |
| No | Yes | |
SVFN4112 |
Max Allowable Monthly Income Standard (en) |
| No | Yes | |
SVFN4113 |
Client Eligible (Gross Income < Max Monthly Standard) (en) |
| No | Yes | |
SVFN4114 |
Individual Gross Earned Income (en) |
| No | Yes | |
SVFN4115 |
Personal Needs Allowance (en) |
| No | Yes | |
SVFN4116 |
Community Needs Spouse Allowance (en) |
| No | Yes | |
SVFN4117 |
Family Dependant Allowance (en) |
| No | Yes | |
SVFN4118 |
Medical Expense Deduction (en) |
| No | Yes | |
SVFN4119 |
Home Maintenance Allowance (en) |
| No | Yes | |
SVFN4120 |
Legal Guardian Expense Deduction (en) |
| No | Yes | |
SVFN4121 |
Contribution Towards Cost Of Care (en) |
| No | Yes | |
SVFN4122 |
Child Countable Resources (en) |
| No | Yes | |
SVFN4123 |
Parent to Child Deeming (en) |
| No | Yes | |
SVFN4124 |
| No | Yes | |
SVFN4125 |
Client Eligible (Total Resources < Limit) (en) |
| No | Yes | |
SVFN4126 |
Individual Countable Resources (en) |
| No | Yes | |
SVFN4127 |
Spouse Countable Resources (en) |
| No | Yes | |
SVFN4128 |
| No | Yes | |
SVFN4129 |
| No | Yes | |
SVFN4130 |
Minimum Spousal Amount (en) |
| No | Yes | |
SVFN4131 |
Individual Spousal Share (en) |
| No | Yes | |
SVFN4132 |
Spouse Spousal Share (en) |
| No | Yes | |
SVFN4133 |
Spousal Transfer Amount Required (en) |
| No | Yes | |
SVFN4134 |
Due Date of Spousal Transfer (en) |
| No | Yes | |
SVFN4135 |
Medically Needy Income Eligibility Standard (en) |
| No | Yes | |
SVFN4136 |
Client Eligible (Total Net Income < MNIES) (en) |
| No | Yes | |
SVFN4137 |
LTC SpendDown Liability (en) |
| No | Yes | |
SVFN4138 |
| No | Yes | |
SVFN4139 |
Client Income-eligible (en) |
| No | Yes | |
SVFN4140 |
Medical Expense Necessary To Meet SpendDown (en) |
| No | Yes | |
SVFN4141 |
Private Cost of Care (en) |
| No | Yes | |
SVFN4142 |
Client Meets SpendDown (Cost of Care >= Liability) (en) |
| No | Yes | |
SVFN4143 |
| No | Yes | |
SVFN4144 |
Mandatory Household Member (en) |
| No | Yes | |
SVFN4145 |
Optional Household Member (en) |
| No | Yes | |
SVFN4146 |
| No | Yes | |
SVFN4147 |
| No | Yes | |
SVFN4148 |
Non Household Member (en) |
| No | Yes | |
SVFN4149 |
Excluded Household Member (en) |
| No | Yes | |
SVFN4150 |
Not Dis-enrolled Due To Premium Nonpayment (en) |
| No | Yes | |
SVFN4151 |
Past Due Premiums Repaid (en) |
| No | Yes | |
SVFN4152 |
| No | Yes | |
SVFN4153 |
| No | Yes | |
SVFN4154 |
| No | Yes | |
SVFN4155 |
Eligible For Medical Assistance (en) |
| No | Yes | |
SVFN4156 |
No Health Insurance Coverage (en) |
| No | Yes | |
SVFN4157 |
Exceeded 90 Days Waiting Period (en) |
| No | Yes | |
SVFN4158 |
Not Involuntarily Resident in Institution (en) |
| No | Yes | |
SVFN4159 |
Not Inpatient In Psychiatric Facility (en) |
| No | Yes | |
SVFN4160 |
| No | Yes | |
SVFN4161 |
Transfer of Assets Penalty (en) |
| No | Yes | |
SVFN4162 |
Lower Net Income Limit (en) |
| No | Yes | |
SVFN4163 |
Upper Net Income Limit (en) |
| No | Yes | |
SVFN4164 |
Resource Limit For Household (en) |
| No | Yes | |
SVFN4165 |
| No | Yes | |