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EXHIBIT I <br />Chapter Three - Calculating Annual (Gross) Income <br />Exhibit 3.3 - Sample Format for Computing Part 5 Annual Income <br />1. Name: 2. Identification No.: <br /> ASSETS <br /> Family <br />Member <br />Asset Description Current Cash Value <br />of Assets Actual Income <br />from Assets <br /> <br /> <br /> <br /> <br /> <br />3. Net Cash Value of Assets ................................ 3. <br />4. Total Actual Income from Assets ................................................................. 4. <br />5. If line 3 is greater than $5,000, multiply line by_ (Passbook Rate) <br />and enter results here; otherwise, leave blank. 5. <br /> ANTICIPATED ANNUAL INCOME <br />Family <br />Members a. Wages/ <br />Salaries b. Benefits/ <br />Pensions c. Public <br />Assistance d. Other <br />Income e. Asset <br />Income <br /> Enter the <br /> greater of <br /> lines 4 or 5 <br /> from above <br /> in e. <br />6. Totals a. b. C. d. e. <br />7. Enter total of items from 6a. through 6e. This is Annual Income ............................. 7. <br />Signature <br />For Office Use Only <br />$ Income Limit <br />$ Income Limit of Household <br />Technical Guide for Determining Income and Allowances for the HOME Program - 23