Chelan PUD Customer Bill Assistance Program — Documents needed for proof of income
Categorical eligibility — qualifying programs
If you are currently enrolled in one of the following programs, you may qualify automatically by providing a current award letter or benefits statement instead of income documentation. The award letter must include:
- The name of a household member
- A date that shows it is current
- The name of an eligible program
Qualifying programs:
- SNAP (food stamps) / Basic Food
- Medicaid / Apple Health
- LIHEAP
- Head Start / Early Head Start
- Lifeline (phone/internet discount)
- Housing Choice Voucher (Section 8) / Public Housing
- USDA Rural Development — Section 502 Direct Home Loans
- USDA Section 521 Rental Assistance
- USDA Section 533 Housing Preservation Grant (HPG)
- USDA Section 504 Home Repair Program
- National School Lunch Program
- TANF
- Weatherization Assistance Program (WAP)
- Women, Infants & Children (WIC)
- Housing Improvement Program (HIP)
If you do not participate in a qualifying program, you will need to provide proof of income for all household members using the documents described in the table below.
Countable Income Documents Needed for Proof of Income
| Income Type | What the Document Must Show | Required Timeframe | Acceptable Documents | Unacceptable Documents |
|---|---|---|---|---|
| $0 income | Recipient name Current date Statement of no income | Current (dated at submission) | Written or typed $0 income statement | Blank or undated statements |
| Alimony / spousal support | Recipient name Payer name Amount received Dates | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | Court order, payment history | Bank statements, self-attestation |
| Child support | Recipient name Amount received Dates | Court order: no strict timeframe, must show current ordered obligation. Payment records: must show at least 28 consecutive days following the standard documentation rule. | Court order, payment record | Bank statements, self-attestation |
| Disability payments | Recipient name Payer name Gross amount Dates | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | Disability award letter | Bank statements, self-attestation |
| Gig Work (e.g., DoorDash, Instacart) | Recipient name Business name (if applicable) Revenue Expenses Net profit Dates covering the required period | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | Profit and Loss statement, payout history, or earning summaries from the gig app. Common examples: rideshare driving (Uber, Lyft), food delivery (DoorDash, Grubhub), freelance services, task-based work (TaskRabbit, Handy) | Tax returns, bank statements, 1099s, or self-attestation alone |
| Insurance or Annuity payments (only if ongoing) | Recipient name Payer Gross amount (or withdrawals) Dates of payment | Within last 12 months | Insurance payout or annuity statement | 1099s, self-attestation |
| Investments and Savings | Recipient name Institution Dates Interest and/or dividends earned | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | Brokerage or bank statement showing earnings, Certificates of Deposit (CDs), bonds | 1099s, self-attestation |
| IRA / 401(k) disbursement | Recipient name Payer/institution Account type Distribution amount Dates | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | Monthly distribution statement Retirement account distribution statement (e.g., Fidelity, Vanguard) Brokerage or retirement account statement showing withdrawal Distribution confirmation or payment advice | 1099s, self-attestation |
| Military / Veteran pay (including allotments / housing allowance) | Recipient name Type Gross amount Dates | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | Military statement, LES | Bank statements, self-attestation |
| Pensions / Retirement income | Recipient name Payer Gross payment amount Dates | Within last 12 months | Pension award letter or statement, CalPERS | 1099s, bank statements, self-attestation |
| Per diem income | Recipient name Payer Gross amount Dates | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | Court or government statement, pay stub | Bank statements, self-attestation |
| Rental income (net) | Recipient name Property Gross rent Expenses Dates | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | Rent ledger (payments, rental charges) Profit & Loss statement (expenses, gross income, net income) | Bank statements, tax returns |
| Retroactive SSA / SSI / Railroad Retirement | Recipient name Lump sum amount Period covered | At time of receipt | Lump sum notice | Bank statements alone, self-attestation |
| Royalties | Recipient name Source of royalty income Gross amount paid Payment dates | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | Royalty statements (e.g., from publisher, distributor, or rights organization) | Bank statements alone; documents showing net amounts only; 1099-MISC or 1099-NEC, self-attestation |
| Self-employment (net profit) | Recipient name Revenue Expenses Net profit Dates | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | Profit & Loss statement, self-employment ledger | Tax returns, bank statements, 1099, self-attestation |
| Social Security (SSA) | Recipient name Benefit type Gross amount Effective date | Within last 12 months | SSA award letter, COLA letter | 1099s, bank statements, self-attestation |
| Unemployment Insurance Benefits (UIB) | Recipient name Benefit type (UIB) Gross weekly or bi-weekly benefit amount Benefit dates | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | WA Employment Security Department (ESD) benefit determination letter; WA ESD payment history | Bank statements; screenshots without recipient name or dates, self-attestation |
| Wages, salaries, commissions (before deductions) | Recipient name Employer name Gross income Pay period dates (or pay dates) | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | Consecutive pay stubs Employer payroll statement (must include YTD so we can determine the pay frequency) Written employer letter (must include all required details including date of the letter) | Bank statements, tax forms (e.g. W2) |
| Worker's Comp | Recipient name Payer name Gross amount Payment dates | If submitted on or before the 15th: documents can go back to the 15th of two months prior. If submitted on or after the 16th: documents can go back to the 1st of last month. Must cover at least 28 consecutive days. | Most recent award letter or benefit determination letter Payment statement from the workers' compensation insurer Official benefit printout showing gross payment amounts and dates Regular payment stubs (if issued) | Bank statements Screenshots of deposits (e.g., mobile banking app images without gross breakdown) Direct deposit alerts (text/email notifications showing only net deposit) Handwritten notes or self-attestation statements Tax documents (e.g. 1040, W-2, 1099) |
| Low-income government program participation | Name of the benefits program Name of the recipient(s) Current participation in the program | Dated within last 12 months from the date of benefit OR shows active status | Benefit letter Portal screenshot showing active benefits or recent deposit | EBT or Medicaid card Expired notices SSA- or Medicare-only letters |