SI 00830: Unearned Income
TN 94 (06-04)
A. Introduction
Form SSA-3991 and form SSA-3992 guide the user through the calculation of monthly earned and unearned income using a leave and earnings statement (LES), as explained in SI 00830.540G. Use of these worksheets is optional.
The worksheet (or PC program) is not needed when the service member is paid only once a month.
B. Procedure
1. Heading
Enter the names, Social Security number, and page number at the top of the form.
Then enter the consecutive LES work months (i.e., the calendar months and years of work).
2. Section I
Enter the verified amounts of pay from the LES for each work month requested.
NOTE: The "Net Pay First-of-Month" entry refers to the second regular payment for the work month, usually issued on the first day of the following month.
3. Section II
Perform the calculations (described in the first column) within each of the columns headed by a work month. Carry each result to 3 decimal places, dropping the fourth digit, if any.
4. Section III
Enter the same months at the top of the "Received in" columns as were entered in the "LES Work Month" columns.
Enter the amounts from the requested cells in Section II (and from the previous worksheet used, if any).
NOTE: In Section III, all cell names in column 1 that begin with "4" are carry-over amounts from the last column of a previous worksheet.Total the entries to obtain chargeable earned and unearned income for each month.
C. Reference
No rounding of income or input entries, SI 02001.010A.2. - SI 02001.010A.3.
D. Exhibits
If you choose to use either the SSA-3991 or the SSA-3992, you must reproduce the appropriate exhibit below; the forms will not be available by order.
The completed example below illustrates use of the SSA-3992 in the situation described in SI 00830.540G.4.
UNIFORMED SERVICES MONTHLY INCOME (Non-Army)
CLAIMANT/RECIPIENT________________________A/N________________________________
SERVICE MEMBER____________________________Page ____ of ____
|
LES Work Month 1 ____/____ |
LES Work Month 2 ____/____ |
LES Work Month 3 ____/____ |
LES Work Month 4 ____/____ |
SECTION I: PAY AMOUNTS FROM THE LES
|
Basic Pay |
1A 808.800 |
2A |
3A |
4A |
|
Total Subsistence |
1B 166.470 |
2B |
3B |
4B |
|
Total Nonsubsistence Allowances and Special Pay |
1C 287.340 |
2C |
3C |
4C |
|
Net Pay Midmonth |
1D 564.020 |
2D |
3D |
4D |
|
Net Pay First-of-Month |
1E 569.390 |
2E |
3E |
4E |
SECTION II: CALCULATIONS (Carry to 3 decimal places.)
|
B ÷ 2 166.470÷ 2 |
1F 83.235 |
2F |
3F |
4F |
|
D – F 564.020 – 83.235 |
1G 480.785 |
2G |
3G |
4G |
|
E – F 569.390 – 83.235 |
1H 486.155 |
2H |
3H |
4H |
|
G + H 480.785 + 486.155 |
1J 966.940 |
2J |
3J |
4J |
|
G ÷ J 480.785 ÷ 966.940 |
1K .497 |
2K |
3K |
4K |
|
K x A .497 x808.800 |
1L 401.973 |
2L |
3l |
4l |
|
A – L 808.800 – 401.973 |
1M 406.827 |
2M |
3M |
4M |
|
K x C 287.340 x .497 |
1N 142.807 |
2N |
3N |
4N |
|
C – N 287.340 – 142.807 |
1O 144.533 |
2O |
3O |
4O |
|
F + N 83.235 + 142.807 |
1P 226.042 |
2P |
3P |
4P |
|
F + O 83.235 + 144.533 |
1Q 227.768 |
2Q |
3Q |
4Q |
SECTION III: CHARGEABLE INCOME BY MONTH OF RECEIPT
|
Received in Month 1 _10/92____ EARNED INCOME 4M*: -- +1L: 401.97_ Total:401.97 UNEARNED INCOME 4Q*: -- +1P:_226.04____ Total: 226.04 |
Received in Month 2 ___11/92____ EARNED INCOME 1M: -- +2L:_401.97 Total:401.97 UNEARNED INCOME 1Q: 227.76 +2P:_226.04____ Total:453.80 |
Received in Month 3 ____/____ EARNED INCOME 2M: +3L:____ Total: UNEARNED INCOME 2Q: +3P:____ Total: |
Received in Month 4 ____/____ EARNED INCOME 3M: +4L:____ Total: UNEARNED INCOME 3Q: +4P:____ Total: |
*CARRIED OVER FROM COLUMN 4 OF PRIOR WORKSHEET
FORM SSA-3992