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I. Financial Inventory Purpose

The Financial Inventory (Form R-406) is used to gather pertinent client financial data and to determine an expected level of client financial participation for services other than post-secondary training. The Financial Inventory includes information as to the dependency status of the client, annualized income data as well as other financial or in-kind resources which the client may apply toward the cost(s) of service(s).

The R-406, Financial Inventory, is to be completed in order to assist in determining an appropriate level of client participation in meeting the financial cost of those vocational rehabilitation services which are based on economic need.

II. Financial Inventory Form

Before beginning the completion of Side A of the R-406, the counselor and client should complete the "Cost of Item/Services" and "Comparable Services and Benefits" sections on Side B. If exact costs or benefits are not known, use your best estimate. Try to project for the whole year.

Client Name: Enter the client’s name.

Counselor: Enter your name.

A. Number of Dependents: Enter the number of dependents claimed on last year’s

Federal Income Tax form which included the client. This should be obtained from

questioning the client and any accompanying family member or representative. In

most cases the counselor need not see the actual form. This number will determine the

amount of income to be excluded.

B. Income Data: If the client is self-supporting, claims his or herself on tax forms, is not

claimed on anyone else’s income tax return, only the client’s resources are

inventoried.

If the client is claimed as a dependent on his or her parent’s or guardian’s tax return,

the parent’s or guardian’s financial status is inventoried.

For the client who is married, it is intended that the financial resources of both the

client and spouse be included in the inventory.

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The income data is intended to reflect the current income of the client/family. Do not

include public assistance benefits. It is important to include gross wages as opposed to

"take home pay". In the case of farm or business income, the figure is intended to

reflect net income. In many instances it will be necessary to estimate net income.

That estimate will be based upon the previous year’s record of income.

Frequently the income data will be provided on the basis of dollars per week or month, rather than per year. When such is the case, the information provided is to be

multiplied by the appropriate figure in order to show it as an annual income. It is

important to be as accurate as possible in assessing the current income of the client

and to annualize that income for the ensuing twelve month period.

C. To Be Completed By Counselor:

1. Add all annualized entries in item B. and put total here.

2. Using the number entered in item A., find the amount of income to be excluded

from Chart A (on back) and enter here.

3. Subtract line C.2. from line C.1. - Enter the number, but not less than zero. This is

the Applicable Income.

4. Required Participation -

a. From Chart B, enter the participation percent for the Applicable Income in the

first blank. Enter the Annual Service Costs you determined on Side B (Item III) in the second blank. Calculate the percent times Annual Service Costs and enter that figure in the last blank.

b. From Chart B, enter the Annual Maximum percentage for the Applicable Income

in the first blank. Enter the Applicable Income from line C.3. in the second

blank. Calculate the percent times the Applicable Income and enter Annual

Maximum required participation in the last blank.

D. DVRS Participation:

1. Enter the smaller of C.4.a. or C.4.b.

2. Subtract any other client/family participation.

3. This is the maximum DVRS participation.

Certification: The client, or person completing the form is simply asked to verify that

the information provided is correct. The respondent should be advised that if the

information provided is challenged, they may be asked to document the financial

information they have provided. The form should then be signed by a DVRS staff

member.

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The financial inventory includes the following table which is used to calculate an income exclusion allowance.

Family Size Income Exclusion Allowance

It also includes a Participation Table to determine the required level of client financial participation. That table follows.

Applicable Income % Participation Annual Maximum

The income exclusion allowance information utilized in the Exclusion Table is adjusted annually to reflect 130% of the current Federal Poverty Guidelines. The schedule of financial participation based on "applicable income" shown on the Participation Table was developed by DVRS and is considered to be reasonable, fair and prudent and is subject to annual review and adjustment.

Individuals, whose annualized income is less than 130% of Federal Poverty Guidelines, are not required to participate.

III. DVRS Unmet Need Determination (Post-Secondary) (Form 283-1383): This form is used to determine unmet need for students in post-secondary training. Standards for the level of DVRS involvement in the defined unmet need are found in section II-D of this handbook.

April, 1999