SELF SUFFICIENCY CALCULATOR

PERSONAL INFORMATION

* indicates a required field

BASIC INFORMATION

Add each person living in the household, including children, adults and elderly

First name *

Last name

County *

Select the County where you live

HOUSEHOLD COMPOSITION

Add each person living in the household, including children, adults and elderly

Person 1 (Primary Applicant)

PERSON 1 (PRIMARY APPLICANT)

Birth year *

Employment status *

Household Summary

HOUSEHOLD SUMMARY:

1 Adult, 0 Children

See Self Sufficiency Standard for this Household

INCOME & PUBLIC ASSISTANCE

* indicates a required field

INCOME DETAILS

Enter income information for each working adult in the household

IMPORTANT:

Enter gross income amounts (before taxes and deductions). Use your most recent pay information or average monthly amounts if income varies.

Add at least one adult in the Personal Information step to enter income details.

OTHER INCOME

Worker's compensation, inheritance, prizes/awards, and dividends or interest received.

Total Other Monthly Income

Add up all sources of other income and enter the total monthly amount

WHAT TO INCLUDE IN OTHER INCOME:

Worker's Compensation

Worker's compensation payments
Monthly cash compensation

Inheritance & Estates

Trust distributions
Estate payments
Inherited annuities

Rental Income

Property rental income
Boarder income payments

Investment Income

Dividend payments
Interest from savings/CDs
Bond interest payments

Prizes & Awards

Lottery winnings
Contest prizes

Other Sources

Alimony received
Royalties
Small business income

HOW TO CALCULATE:

If you receive income on an irregular basis, calculate your average monthly amount. If you receive payments quarterly or annually, divide by 3 or 12 to get the monthly amount. For irregular income, estimate your average monthly amount over the past year.

INCOME FROM PUBLIC ASSISTANCE

Enter monthly amounts for any assistance programs your household receives

Child support

Monthly amount received

SNAP (Food Stamps)

Monthly benefit amount

SSI (Supplemental Security Income)

Monthly benefit amount

TANF (Temporary Assistance)

Monthly cash assistance

Other assistance

Housing vouchers, utility assistance, etc.

BENEFIT CLIFFS: WANT TO EXPLORE HOW INCOME CHANGES MIGHT AFFECT BENEFIT ELIGIBILITY?

Use the Atlanta Federal Reserve's Benefit Cliff Calculator as a reference tool to understand how earnings changes can impact public benefits.

EXPENSES

Enter your actual monthly expenses. If you don't know exact amounts, use your best estimate based on recent bills and spending patterns.

* indicates a required field

HOUSING & UTILITIES

Rent/mortgage and utilities

Monthly housing cost (after assistance if applicable) *

Total monthly utilities (after assistance if applicable) *

WHAT TO INCLUDE IN UTILITIES:

Electricity and gas bills
Water and sewer
Internet and phone bills
Trash/recycling services

CHILD CARE

Daycare, babysitting, and child support payments

Does an adult in your household stay home to care for children instead of working?

Yes, an adult caregiver stays home No, all adults work or seek work

This affects both childcare costs and income calculations in your self-sufficiency standard.

Monthly childcare expenses

Daycare, preschool, after-school care costs (after assistance if applicable)

Child support expenses

Monthly payments to custodial parent/guardian

HEALTH CARE

Insurance premiums and medical expenses

Monthly health insurance premiums

Your portion of health insurance costs

Out-of-pocket medical expenses

Co-pays, prescriptions, dental, vision

FOOD

Groceries and dining expenses

Monthly food expenses *

Groceries and dining out (after SNAP benefits if applicable)

TRANSPORTATION

Vehicle and travel expenses

Monthly transportation costs

Car payment, gas, insurance, maintenance, public transit

INCLUDE THESE COSTS IN TRANSPORTATION EXPENSES:

Car loan or lease payment
Auto insurance
Gasoline/fuel
Public transportation fares
Parking fees

OTHER ESSENTIAL EXPENSES

Personal care, clothing, and miscellaneous

Miscellaneous expenses

Personal care, clothing, household items, and other expenses not listed above

MISCELLANEOUS COULD INCLUDE:

Toiletries
Cleaning supplies
Laundry/dry cleaning
Clothing
Haircuts
Work expenses
Education costs

WRITE-IN EXPENSES

Add debts, loans, subscriptions and other expenses

COMMON WRITE-IN EXPENSES INCLUDE:

Credit card payments
Student loan payments
Spousal/family maintenance
Gym memberships
Pet insurance

Expense name

Monthly cost

TOTAL $0

REVIEW INFORMATION

Make sure your information is correct before proceeding to the Self Sufficiency report.

PERSONAL INFORMATION

Client Name —

County —

Household —

MONTHLY INCOME

Other Monthly Income $0.00

Assistance Programs $0.00

Total Estimated Household Monthly Income $0.00

MONTHLY EXPENSES

Adult Caregiving Status Not specified

Total Reported Monthly Expenses $0.00

SELF SUFFICIENCY REPORT

Detailed comparison of your household income and expenses against the Self-Sufficiency Standard.

Self Sufficiency Report —

Client Name —

County: —

Household: —

Programs: —

$0.00

Current Monthly Income

—

of Self-Sufficiency Standard

—

Self-Sufficiency Standard

—

Required Hourly Wage (per adult): —

Monthly Income Needed: —

Annual Income Needed: —

Income vs. Self-Sufficiency Standard

Category	Self-Sufficiency Standard Income	Customer's Income at Registration	Difference

Monthly Expenses

Category	Self-Sufficiency Standard Expenses	Customer's Expenses at Registration	Difference