SSI Budget Worksheet Form PDF Details

Understanding the SSI Budget Worksheet form is crucial for anyone acting as a representative payee for beneficiaries of Social Security or Supplemental Security Income (SSI). This detailed form is designed to help manage and report the beneficiary's income and expenses accurately. It provides a structured way to document the amount of Social Security or SSI benefits received, along with expenses categorized under food and housing, clothing, medical/dental, personal items, recreation, and miscellaneous. Completing this form is a critical step in ensuring that all financial activities are properly recorded, with totals for the reporting period clearly outlined for easy reference on the Representative Payee Report (Form SSA-623, SSA-6230 or SSA-6233). Additionally, it guides the representative payee on how to report any saved benefits, including interest earned, which is essential for transparent and accountable financial management. The requirement to keep these records for two years and the provision of a sample form simplify the process of tracking expenditures throughout the year. Importantly, this worksheet emphasizes the responsibility of the representative payee to complete the Representative Payee Report annually, regardless of whether they are a legal guardian, underscoring the accountability in handling a beneficiary's finances. Providing space for 11 monthly entries and the option to request additional worksheets, the SSI Budget Worksheet form is a vital tool for meticulous financial planning and reporting.

QuestionAnswer
Form Name SSI Budget Worksheet Form
Form Length 2 pages
Fillable? No
Fillable fields 0
Avg. time to fill out 30 sec
Other names ssi income and expenses worksheet, social security income and expenses worksheet, social security income and expense worksheet, social security expenses form

Form Preview Example

INCOME AND EXPENSES WORKSHEET

Month

and Year

Amount of

Social Security or SSI Benefits Received

Expenses

for Food

and Housing

Expenses for

Clothing,

Medical/Dental, Personal Items, Recreation, Miscellaneous

Totals for Report Period

$ ____________

$ ____________

Put this figure on line 3B of the Form SSA- 623

$______________

Put this figure on line 3C of the Form SSA- 623

Show the total amount of any benefits you saved for the beneficiary, including any interest earned.

$_____________

Put this figure on line 3D of the Form SSA-- 623

Keeping Records

As a representative payee, you're responsible for keeping records and reporting on the use of benefits by completing a Representative Payee Report (Form SSA-623, SSA-6230 or SSA-6233). You should keep these records for two years from the time you complete the form. A sample form is shown below. The appropriate form will be mailed to you about once a year.

You must complete the report even if you are a legal guardian; the accounting you make to the court cannot be substituted. However, much of the information may be the same.

You may choose to use the worksheet in this booklet to help you keep track of your expenditures. Space is provided for 11 monthly entries. When you need to fill out the Representative Payee Report, you can add the amounts in each column of your worksheet and put the totals on the accounting form. If you need additional worksheet space, call Social Security for another copy of the worksheet.

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Tips on how to fill in social security budget sheet part 1

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Find out how to fill out social security budget sheet part 2

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