Page 21 - Indiana
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Proof of Eligibility:
Guidelines and Examples
Income-Based Eligibility Examples
When determining whether a customer qualifies through the income eligibility method, it is
important that the income statement/document is from the past year. If not, the customer will not
be approved.
2020 Federal 135% Poverty Guidelines for Indiana
Household Income
Members Guidelines
1 member $17,226
2 members $23,274
3 members $29,322
4 members $35,370
5 members $41,418
6 members $47,466
7 members $53,514
8 members $59,562
Add’l members $6,048
Tax Return Document:
12
Proprietary and Confidential 1/20/2020
