Appendix D7. Household Survey Income Source Show Card

APPENDIX D7. HOUSEHOLD SURVEY INCOME SOURCE SHOW CARD

OMB Number: 0584-0530

Expiration Date: XX/XX/XXXX

National School Meals Study Show Card 1

Household Income and Benefit Payments

SOURCE #	TYPE OF INCOME OR BENEFITS PAYMENT
Source 1	Income for paid work If you have your own business, only include the salary you pay yourself as personal income or regular earnings. Do not include the business profits or losses. For military service members, include Military Basic Pay. For deployed service members, include only the amount made available to the household.
Source 2	Unemployment Compensation Money that substitutes for wages or salary, paid to recently unemployed workers under a program administered by a government or labor union.
Source 3	Workers Compensation Benefits Payment that is required by law to be made to an employee who is injured or disabled in connection with work.
Source 4	Strike Benefits Money paid to strikers by a union to enable them to be supported during a strike.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-0530. The time required to complete this information collection is estimated to average 2 minutes per response, including the time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the collection of information. Source 5	Social Security or Railroad Retirement Railroad retirement program provides retirement, survivor unemployment and sickness benefits to individuals who have spent a substantial portion of their career in railroad employment, as well as to workers’ families. Social Security Retirement is a federal insurance program that provides benefits to retired people and those who are unemployed or disabled.
Source 6	Pensions (public or private), Annuities, or Survivor’s Benefits A pension is a fund into which a sum of money is added during an employee's employment years, and from which payments are drawn to support the person's retirement from work in the form of periodic payments. An annuity is a contract between you and an insurance company that requires the insurer to make payments to you, either immediately or in the future. You buy an annuity by making either a single payment or a series of payments. Similarly, your payout may come either as one lump-sum payment or as a series of payments over time. Survivor's benefits are for widows and widowers receiving monthly Social Security benefits based on their deceased spouse’s earnings records.
Source 7	Military Cash Benefits Cash benefits for housing, food, or clothing allowances, including the Basic Allowance for Housing (BAH). Do not include combat pay, or benefits from the Family Substance Supplemental Allowance (FSSA) or the Military Housing Privatization Initiative (MHPI). For deployed service members, only include the amount made available to the household.
Source 8	Veteran’s Benefits Benefits you receive based on military service.
Source 9	Government Disability Benefits from Supplementary Security Income (SSI) SSI program pays benefits to disabled adults and children who have limited income and resources.
Source 10	Private Disability Benefits Providing benefits to employees who are unable to work due to disability, by paying all or part of their salaries from an insurance policy that can be provided by an employer as an employee benefit, or an insurance policy that can be purchased by an individual directly from an insurance company.
Source 11	Alimony Payments Payments made in a lump sum or on a continuing basis to provide financial support to a spouse before or after a marital separation or divorce. Alimony does NOT include child support, noncash property settlements, payments to keep up the payer’s property or use of the payer’s property.
Source 12	Child Support Payments Ongoing payment made by a parent to contribute to the costs of raising her or his child following the end of a marriage or other relationship.
Source 13	Interest and Dividends Income A dividend is a distribution of a portion of a company's earnings, decided by the board of directors, to a class of its shareholders. Dividends can be issued as cash payments, as shares of stock, or other property. Interest earned on investments is interest income.
Source 14	Net rental income The amount someone pays you to use your property, after you subtract the expenses you have for the property.
Source 15	Profit or Loss from Nonfarm Business, Partnership, or Professional Practice This is profit or loss not included in the salary you pay yourself as personal income or regular earnings.
Source 16	Profit or Loss from a Farm Income gained or loss from growing crops, raising livestock, breeding fish or operating a ranch.
Source 17	Financial Aid to College Students Include money used for room and board, do NOT include money used for tuition, books, and fees, or Pell Grants, Supplemental Education Opportunity Grants, State Student Incentive Grants, National Direct Student Loans, PLUS, College Work Study, or Byrd Honor Scholarship Programs.
Source 18	Regular Payments or Withdrawals from Large Awards or Settlements Include income from legal settlements, inheritance, prize winnings, or bonuses.
Source 19	Regular Contributions from Persons Outside the Household Include cash gifts or other financial assistance from friends or family.
Source 20	Other Income, such as Net Royalties, Trust Income, or 401K.
Source 21	General Assistance Benefits State or county programs serving low-income individuals who do not have minor children, are not disabled enough to qualify for (or do not yet receive) Supplemental Security Income (SSI), and are not elderly.
Source 22	Housing Subsidy (do not include Federal housing subsidies) Subsidized housing is owned and operated by private owners who receive subsidies in exchange for renting to low- and moderate-income people. Owners may be individual landlords or for-profit or nonprofit corporations. This does not include subsidized housing programs overseen by the U.S. Dept. of Housing and Urban Development (HUD) such as Section 8 or the Rural Rental Assistance program managed by the USDA.
Source 23	Federal Black Lung Program Provides compensation to coal miners who are totally disabled by pneumoconiosis arising out of coal mine employment, and to survivors of coal miners whose deaths are attributable to the disease and provides eligible miners with medical coverage for the treatment of lung diseases related to pneumoconiosis.
Source 24	Other Public Benefits, not including TANF or SNAP Other benefits such as Women, Infants and Children (WIC) or State Children’s Health Insurance (SCHIP) Do not include TANF or SNAP benefits.
Source 25	Select if person has no source of income or benefits.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXXX. The time required to complete this information collection is estimated to average 2 minutes per response, including the time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the collection of information.

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