Income Verification Requirements

Income Verification is a requirement of PeachCare for Kids®.
Please provide all requested information within 14 days.
New Application:
When you apply for PeachCare for Kids, your income will be verified.
When you apply online, an Income Verification Form is available to fax or mail.
Existing Accounts:
To continue your eligibility, your income will be verified every year. You will receive a letter when it is time to renew your account.

To print out an Income Verification Form, please visit the documents page, or you can call PeachCare for Kids toll-free at 877-GA-PEACH (877-427-3224) and request the Income Verification Form.
Income Verification Includes:

All income information must be the most current or recent information
A.  Earned Income — Money anyone in the household receives.

  • Weekly pay — four (4) weeks of pay stubs (one (1) week after the other) - OR -
  • Bi-Weekly pay — two (2) pay stubs received every other week (one (1) after the other) - OR -
  • Semi-Monthly — two (2) pay stubs received two (2) times a month (one (1) after the other) - OR -
  • Monthly — two (2) pay stubs received one (1) time a month (one (1) month after another) - OR -
  • Paid in cash — Employer Verification Form must be completed by the employer. Employer must list dates and amounts for four consecutive weeks or 1 month of paystubs.

B.  Unearned Income — Money anyone in the household receives from any agencies, parents or relatives, friends, or any other sources.

  • Unemployment check — four (4) weeks of pay stubs (one week after the other)
  • Interest (taxable and non taxable)
  • Social Security (SSA) income
  • Dividends
  • Taxable state income tax refunds and credits
  • Portion of scholarships, awards or fellowship grants used for living expenses
  • Alimony received
  • Capital/other gain
  • IRA distributions (taxable amount only)
  • Annuities
  • Rental real estate income and royalties
  • Pension retirement benefits, stocks or bonds dividends — send the most recent award letter
  • Student loans, grants and scholarships — send current-year award letter
  • Other Unearned Income — provide letter stating amount received and how often received. Provide name, address, and contact number or four (4) weeks of pay stubs (one week after the other)

C.  Income Deductions — Deductions are things you pay for that can be deducted on a federal income tax return.

  • Estate and trust loss
  • Educator expenses (limit of $250 per educator in a tax year)
  • Real estate mortgage investment loss
  • Business expenses of Reservists, Performing Artists, and Fee-Basis Government Officials
  • Health Savings Account Deduction (limit of $271/month for single filer, and $538 for a family)
  • Moving expenses (if moved in connection with new job)
  • Self-employed SEP, SIMPLE and qualified plans
  • Self-employed health insurance deduction
  • Penalty on early withdrawal of savings
  • Alimony Paid
  • IRA deduction
  • Student loan interest (limit of $2,500 in a tax year)
  • Tuition and fees (limit of $4,000 in a tax year
  • Domestic production activities deduction (up to 9% of qualified production activities)
  • Business/Self-employment expenses, including:
    • farm expenses,
    • depreciation,
    • capital losses (limit of $3,000, or $1,500 if married filing separately, in a tax year),
    • rental/real estate losses,
    • partnership and S Corporations losses, and
    • royalties loss