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{"sheet":"1st Earner","index":0,"n_rows":73,"n_cols":12,"rows_kept":73,"cut":false,"hidden":true,"merged":[[11,2,11,4],[44,8,44,10],[46,8,46,10],[17,2,17,3],[15,2,15,4],[43,0,43,2],[13,0,13,1],[17,0,17,1],[48,4,48,6],[44,0,44,2],[45,8,45,10],[6,4,6,5],[15,0,15,1],[11,7,11,11],[13,2,13,4],[26,7,26,11],[45,0,45,2],[19,0,19,1],[43,8,43,10],[27,3,27,4],[32,11,41,11],[12,7,23,11],[8,0,8,1],[11,0,11,1],[0,0,0,3],[1,0,1,3],[2,0,2,3],[1,4,1,9],[5,0,5,1],[62,7,62,11],[47,1,47,7],[59,0,69,6],[72,2,72,4],[72,8,72,9],[59,8,59,9],[60,8,60,9],[50,0,50,6],[50,7,50,11],[58,0,58,6],[52,8,52,9],[53,8,53,9],[54,8,54,9],[57,8,57,9],[58,8,58,9],[68,9,68,10]]}
["State Of Kansas",null,null,null,null,null,null,null,null,null,null,"ES-3103"]
["Department for Children and Families",null,null,null,"Income/Expense Worksheet",null,null,null,null,null,null,"2018-01-24"]
["Economic And Employment Services"]
[]
[]
["Case Name"]
[null,null,"(Last)","(First)","(Case#)"]
[null,null,null,null,null,null,null,"Initial",null,"Review"]
["Benefit Month"]
[null,null,"(Month)",null,"(Year)",null,null,"IR",null,"Change"]
[]
["Employee",null,null,null,null,null,null,"LOCAL AGENCY USE"]
[null,null,null,null,null,null,null,"\n"]
["Employer"]
[]
["Employer's Address"]
[]
["Hours Scheduled"]
[]
["Frequency Paid",null,"Weekly",null,"Bi-Weekly"]
[]
[null,null,"Semi-Monthly",null,"Monthly"]
[]
[null,"Pay Day"]
[]
[null,"Best Estimate",null,null,"Actual"]
[null,null,null,null,null,null,null,"THIS IS GENERAL INCOME CALCULATION WORKSHEET"]
[null,"Past 30 Days",null,"More Than 30 Days"]
[]
[null,null,null,null,"Hours",null,null,"Bonus",null,0,"Countable"]
["#","Check Date","Pay Rate","Hours","For","Regular Pay","Overtime","Tips","Total Pay","If Not","Towards","Notes"]
[null,null,null,null,"Average","(see note at right)",null,"Other",null,"Rep","Average"]
[1,null,null,null,{"$f":"IF(J33=1,D33)","v":false},{"$f":"C33*D33","v":0},null,null,{"$f":"SUM($F$33:$H$33)","v":0},{"$f":"IF(I33>0,1,0)","v":0},{"$f":"IF(J33=1,I33)","v":false},"If the auto-calculated amount is incorrect, manually input the correct amount of regular pay"]
[2,null,null,null,false,{"$f":"C34*D34","v":0},null,null,{"$f":"SUM($F$34:$H$34)","v":0},0,false]
[3,null,null,null,false,{"$f":"C35*D35","v":0},null,null,{"$f":"SUM($F$35:$H$35)","v":0},0,false]
[4,null,null,null,false,{"$f":"C36*D36","v":0},null,null,{"$f":"SUM($F$36:$H$36)","v":0},0,false]
[5,null,null,null,false,{"$f":"C37*D37","v":0},null,null,{"$f":"SUM($F$37:$H$37)","v":0},0,false]
[6,null,null,null,false,0,null,null,{"$f":"SUM($F$38:$H$38)","v":0},0,false]
[7,null,null,null,false,0,null,null,{"$f":"SUM($F$39:$H$39)","v":0},0,false]
[8,null,null,null,false,0,null,null,{"$f":"SUM($F$40:$H$40)","v":0},0,false]
[9,null,null,null,false,0,null,null,{"$f":"SUM($F$41:$H$41)","v":0},0,false]
[10,null,null,null,false,0,null,null,{"$f":"SUM($F$42:$H$42)","v":0},0,false]
[]
["Weekly Average",null,null,{"$f":"IF(D20=\"x\", L46, \"0\")","v":"0"},"  x  4.3    =",{"$f":"$D$44*4.3","v":0},null,null,"Number Of Paychecks In Average",null,null,{"$f":"SUM($J$33:$J$42)","v":0}]
["Bi-Weekly Average",null,null,{"$f":"IF(F20=\"x\", L46, \"0\")","v":"0"},"  x  2.15  =",{"$f":"$D$45*2.15","v":0},null,null,"Total Countable Gross Income",null,null,{"$f":"SUMIF(J33:J42, \"1\",K33:K42)","v":0}]
["Semi-Monthly Average",null,null,{"$f":"IF(D22=\"x\", L46, \"0\")","v":"0"},"  x  2       =",{"$f":"$D$46*2","v":0},null,null,"Average Per Paycheck",null,null,{"$f":"L45/L44","v":{"$error":"#DIV/0!"}}]
[null,null,null,null,null,{"$f":"SUM(F44:F46)","v":0},null,null,"Average Hours Per Pay Period",null,null,{"$f":"AVERAGE(E33:E42)","v":{"$error":"#DIV/0!"}}]
[null,{"$f":"IF(F44>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\",IF(F45>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\",IF(F46>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\",IF(L49>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\",IF(L45>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\",IF(#REF!>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\"))))))","v":{"$error":"#REF!"}}]
[null,null,null,null,"Average Hours Per Pay Period",null,null,null,"x   Pay Rate",null,null,{"$f":"H49*J49","v":0}]
[]
["UNEARNED INCOME",null,null,null,null,null,null,"EXPENSES"]
[null,"Child Support","Number of ","Amount","Others","Amount"]
[null,"Income","Children","Per Child ","UC",null,null,null,"Rent/Mortgage"]
[null,"AP 1",{"$f":"'Child Support'!C19","v":0},{"$f":"'Child Support'!C20","v":{"$error":"#DIV/0!"}},"SS DS",null,null,null,"Lot Rent"]
[null,"AP 2",{"$f":"'Child Support'!C28","v":0},{"$f":"'Child Support'!C29","v":{"$error":"#DIV/0!"}},"SS OT",null,null,null,"Taxes"]
[null,"AP 3",{"$f":"'Child Support'!C37","v":0},{"$f":"'Child Support'!C38","v":{"$error":"#DIV/0!"}},"SI",null,null,null,"Insurance"]
[null,"AP 4",{"$f":"'Child Support'!C46","v":0},{"$f":"'Child Support'!C47","v":{"$error":"#DIV/0!"}},"Other",null,null,null,"Dependent Care"]
[null,"Total CS Income per month",null,{"$f":"'Child Support'!C52","v":0},null,null,null,null,"Family Fee"]
["COMPUTATIONS AND NOTES",null,null,null,null,null,null,null,"Child Support"]
[null,null,null,null,null,null,null,null,"Medical"]
[null,null,null,null,null,null,null,null,"Other"]
[]
[null,null,null,null,null,null,null,"UTILITIES"]
[]
[null,null,null,null,null,null,null,null,null,"Actual",null,"SUA"]
[]
[null,null,null,null,null,null,null,null,null,"LUA",null,"LIEAP"]
[]
[null,null,null,null,null,null,null,null,null,"Telephone Standard"]
[]
[]
[]
[null,"Completed By:",null,null,null,null,null,"Date:",{"$f":"TODAY()","v":"2018-06-28"}]

{"sheet":"2nd Earner","index":1,"n_rows":73,"n_cols":12,"rows_kept":73,"cut":false,"hidden":true,"merged":[[52,8,52,9],[46,8,46,10],[50,0,50,6],[50,7,50,11],[12,7,23,11],[43,8,43,10],[15,0,15,1],[17,0,17,1],[11,0,11,1],[13,0,13,1],[48,4,48,6],[58,0,58,6],[43,0,43,2],[47,1,47,6],[49,1,49,6],[19,0,19,1],[44,0,44,2],[0,0,0,3],[1,0,1,3],[2,0,2,3],[1,4,1,9],[5,0,5,1],[72,2,72,4],[72,8,72,9],[62,7,62,11],[59,8,59,9],[60,8,60,9],[68,9,68,10],[59,0,69,6],[6,4,6,5],[57,8,57,9],[58,8,58,9],[11,2,11,4],[13,2,13,4],[15,2,15,4],[17,2,17,3],[11,7,11,11],[27,3,27,4],[44,8,44,10],[45,8,45,10],[45,0,45,2],[32,11,41,11],[8,0,8,1],[53,8,53,9],[54,8,54,9]]}
["State Of Kansas",null,null,null,null,null,null,null,null,null,null,"ES-3103"]
["Department for Children and Families",null,null,null,"INCOME CALCULATION WORKSHEET",null,null,null,null,null,null,{"$f":"'1st Earner'!L2","v":"2018-01-24"}]
["Economic And Employment Services"]
[]
[]
["Case Name",null,{"$f":"'1st Earner'!C6","v":0},{"$f":"'1st Earner'!D6","v":0},{"$f":"'1st Earner'!E6","v":0}]
[null,null,"(Last)","(First)","(Case#)"]
[null,null,null,null,null,null,null,"Initial",{"$f":"'1st Earner'!I8","v":0},"Review",{"$f":"'1st Earner'!K8","v":0}]
["Benefit Month",null,{"$f":"'1st Earner'!C9","v":0},null,{"$f":"'1st Earner'!E9","v":0}]
[null,null,"(Month)",null,"(Year)",null,null,"IR",{"$f":"'1st Earner'!I10","v":0},"Change",{"$f":"'1st Earner'!K10","v":0}]
[]
["Employee",null,null,null,null,null,null,"LOCAL AGENCY USE"]
[]
["Employer"]
[]
["Employer's Address"]
[]
["Hours Scheduled"]
[]
["Frequency Paid",null,"Weekly",null,"Bi-Weekly"]
[]
[null,null,"Semi-Monthly",null,"Monthly"]
[]
[null,"Pay Day"]
[]
[null,"Best Estimate",null,null,"Actual"]
[]
[null,"Past 30 Days",null,"More Than 30 Days"]
[]
[null,null,null,null,"Hours",null,null,"Bonus",null,0,"Countable"]
["#","Check Date","Pay Rate","Hours","For","Regular Pay","Overtime","Tips","Total Pay","If Not","Towards","Notes"]
[null,null,null,null,"Average","(see note at right)",null,"Other",null,"Rep","Average"]
[1,null,null,null,{"$f":"IF(J33=1,D33)","v":false},{"$f":"C33*D33","v":0},null,null,{"$f":"SUM(F33:H33)","v":0},{"$f":"IF(I33>0,1,0)","v":0},{"$f":"IF(J33=1,I33)","v":false},"If the auto-calculated amount is incorrect, manually input the correct amount of regular pay"]
[2,null,null,null,false,{"$f":"C34*D34","v":0},null,null,0,0,false]
[3,null,null,null,false,{"$f":"C35*D35","v":0},null,null,0,0,false]
[4,null,null,null,false,0,null,null,0,0,false]
[5,null,null,null,false,0,null,null,0,0,false]
[6,null,null,null,false,0,null,null,0,0,false]
[7,null,null,null,false,0,null,null,0,0,false]
[8,null,null,null,false,0,null,null,0,0,false]
[9,null,null,null,false,0,null,null,0,0,false]
[10,null,null,null,false,0,null,null,0,0,false]
[]
["Weekly Average",null,null,{"$f":"IF(D20=\"x\", L46, \"0\")","v":"0"},"  x  4.3    =",{"$f":"$D$44*4.3","v":0},null,null,"Number Of Paychecks In Average",null,null,{"$f":"SUM($J$33:$J$42)","v":0}]
["Bi-Weekly Average",null,null,{"$f":"IF(F20=\"x\", L46, \"0\")","v":"0"},"  x  2.15  =",{"$f":"$D$45*2.15","v":0},null,null,"Total Countable Gross Income",null,null,{"$f":"SUMIF(J33:J42, \"1\",K33:K42)","v":0}]
["Semi-Monthly Average",null,null,{"$f":"IF(D22=\"x\", L46, \"0\")","v":"0"},"  x  2       =",{"$f":"$D$46*2","v":0},null,null,"Average Per Paycheck",null,null,{"$f":"L45/L44","v":{"$error":"#DIV/0!"}}]
[null,null,null,null,null,{"$f":"SUM(F44:F46)","v":0},null,null,"Average Hours Per Pay Period",null,null,{"$f":"AVERAGE($E$33:$E$42)","v":{"$error":"#DIV/0!"}}]
[null,{"$f":"IF(F44>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\",IF(F45>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\",IF(F46>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\",IF(L49>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\",IF(L45>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\",IF(#REF!>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\"\"\"))))))","v":{"$error":"#REF!"}}]
[null,null,null,null,"Average Hours Per Pay Period",null,null,null,"x   Pay Rate",null,null,{"$f":"$H$49*$J$49","v":0}]
[]
["UNEARNED INCOME",null,null,null,null,null,null,"EXPENSES"]
[null,"Child Support","Number of ","Amount","Others","Amount"]
[null,"Income","Children ","per child ","UC",null,null,null,"Rent/Mortgage"]
[null,"AP 1",{"$f":"'Child Support'!C19","v":0},{"$f":"'Child Support'!C20","v":{"$error":"#DIV/0!"}},"SS DS",null,null,null,"Lot Rent"]
[null,"AP 2",{"$f":"'Child Support'!C28","v":0},{"$f":"'Child Support'!C29","v":{"$error":"#DIV/0!"}},"SS OT",null,null,null,"Taxes"]
[null,"AP 3",{"$f":"'Child Support'!C37","v":0},{"$f":"'Child Support'!C38","v":{"$error":"#DIV/0!"}},"SI",null,null,null,"Insurance"]
[null,"AP 4",{"$f":"'Child Support'!C46","v":0},{"$f":"'Child Support'!C47","v":{"$error":"#DIV/0!"}},"Other ",null,null,null,"Dependent Care"]
[null,"Total CS Income per Month",null,{"$f":"'Child Support'!C52","v":0},null,null,null,null,"Family Fee"]
["COMPUTATIONS AND NOTES",null,null,null,null,null,null,null,"Child Support"]
[null,null,null,null,null,null,null,null,"Medical"]
[null,null,null,null,null,null,null,null,"Other"]
[]
[null,null,null,null,null,null,null,"UTILITIES"]
[]
[null,null,null,null,null,null,null,null,null,"Actual",null,"SUA"]
[]
[null,null,null,null,null,null,null,null,null,"LUA",null,"LIEAP"]
[]
[null,null,null,null,null,null,null,null,null,"Telephone Standard"]
[]
[]
[]
[null,"Completed By:",{"$f":"'1st Earner'!C73:E73","v":0},null,null,null,null,"Date:",{"$f":"TODAY()","v":"2018-06-28"}]

{"sheet":"Child Support","index":2,"n_rows":67,"n_cols":12,"rows_kept":67,"cut":false,"hidden":true,"merged":[[41,2,41,3],[42,2,42,3],[24,2,24,3],[31,2,31,3],[32,2,32,3],[33,2,33,3],[40,2,40,3],[13,2,13,3],[14,2,14,3],[15,2,15,3],[22,2,22,3],[23,2,23,3],[0,0,0,3],[1,0,1,3],[2,0,2,3],[1,4,1,9],[5,0,5,1],[55,8,55,9],[66,2,66,4],[66,8,66,9],[61,1,61,11],[62,1,62,11],[63,1,63,11],[55,1,55,6],[54,1,54,6],[6,4,6,5],[60,1,60,11],[58,1,58,11],[59,1,59,11],[57,1,57,11],[56,1,56,11],[50,4,50,5],[51,4,51,5],[50,7,50,8],[51,7,51,8],[8,0,8,1],[50,10,50,11],[51,10,51,11],[52,8,52,9],[54,8,54,9]]}
["State Of Kansas",null,null,null,null,null,null,null,null,null,null,"ES-3103"]
["Department for Children and Families",null,null,null,"CHILD SUPPORT WORKSHEET",null,null,null,null,null,null,{"$f":"'1st Earner'!L2","v":"2018-01-24"}]
["Economic And Employment Services"]
[]
[]
["Case Name",null,{"$f":"'1st Earner'!C6","v":0},{"$f":"'1st Earner'!D6","v":0},{"$f":"'1st Earner'!E6","v":0}]
[null,null,"(Last)","(First)","(Case#)"]
[null,null,null,null,null,null,null,"Initial",{"$f":"'1st Earner'!I8","v":0},"Review",{"$f":"'1st Earner'!K8","v":0}]
["Benefit Month",null,{"$f":"'1st Earner'!C9","v":0},null,{"$f":"'1st Earner'!E9","v":0}]
[null,null,"(Month)",null,"(Year)",null,null,"IR",{"$f":"'1st Earner'!I10","v":0},"Change",{"$f":"'1st Earner'!K10","v":0}]
[]
[]
[]
[null,"Child(ren) #1",null,null,"DATE","MONTH 1",null,"DATE","MONTH 2",null,"DATE","MONTH 3"]
[null,"Court Order"]
[null,"AP's Name"]
[]
[null,"Monthly Avg",{"$f":"(F20+I20+L20)/3","v":0}]
[null,"No of children "]
[null,"Per child ",{"$f":"C18/C19","v":{"$error":"#DIV/0!"}},null,"Total",{"$f":"SUM(F15:F19)","v":0},null,"Total",{"$f":"SUM(I15:I19)","v":0},null,"Total",{"$f":"SUM(L15:L19)","v":0}]
[]
[]
[null,"Child(ren) #2",null,null,"DATE","MONTH 1",null,"DATE","MONTH 2",null,"DATE","MONTH 3"]
[null,"Court Order"]
[null,"AP's Name"]
[]
[null,"Monthly Avg",{"$f":"(F29+I29+L29)/3","v":0}]
[null,"No of children "]
[null,"Per child ",{"$f":"C27/C28","v":{"$error":"#DIV/0!"}},null,"Total",{"$f":"SUM(F24:F28)","v":0},null,"Total",{"$f":"SUM(I24:I28)","v":0},null,"Total",{"$f":"SUM(L24:L28)","v":0}]
[]
[]
[null,"Child(ren) #3",null,null,"DATE","MONTH 1",null,"DATE","MONTH 2",null,"DATE","MONTH 3"]
[null,"Court Order"]
[null,"AP's Name"]
[]
[null,"Monthly Avg",{"$f":"(F38+I38+L38)/3","v":0}]
[null,"No of children "]
[null,"Per child",{"$f":"C36/C37","v":{"$error":"#DIV/0!"}},null,"Total",{"$f":"SUM(F33:F37)","v":0},null,"Total",{"$f":"SUM(I33:I37)","v":0},null,"Total",{"$f":"SUM(L33:L37)","v":0}]
[]
[]
[null,"Child(ren) #4",null,null,"DATE","MONTH 1",null,"DATE","MONTH 2",null,"DATE","MONTH 3"]
[null,"Court Order"]
[null,"AP's Name"]
[]
[null,"Montly Avg",{"$f":"(F47+I47+L47)/3","v":0}]
[null,"No of children "]
[null,"Per child ",{"$f":"C45/C46","v":{"$error":"#DIV/0!"}},null,"Total",{"$f":"SUM(F42:F46)","v":0},null,"Total",{"$f":"SUM(I42:I46)","v":0},null,"Total",{"$f":"SUM(L42:L46)","v":0}]
[]
[]
[]
[null,"Grand Total",{"$f":"SUM(E52,H52,K52)","v":0},null,"Month 1 Total",null,null,"Month 2 Total",null,null,"Month 3 Total"]
[null,"Average Mo",{"$f":"C51/3","v":0},null,{"$f":"F20+F29+F38+F47","v":0},null,null,{"$f":"I20+I29+I38+I47","v":0},null,null,{"$f":"L20+L29+L38+L47","v":0}]
[]
[]
[null,{"$f":"IF(C52>400,\"IF HOUSHOLD SIZE IS 3 OR 4 AND BENEFIT AMOUNT IS $400 OR MORE A PRE-AUTH IS NEEDED\")","v":false}]
[]
[null,"ATTENTION"]
[]
[null,"IF AP BEGINS TO PAY CHILD SUPPORT, USE COURT ORDER OBLIGATION AMOUNT."]
[]
[null,"IF AP IS CURRENTLY PAYING CHILD SUPPORT, USE AVERAGE OF MOST RECENT PAST 3 FULL MONTHS INCLUDING $0.00 PAYMENTS."]
[]
[null,"LUMP SUM CHILD SUPPORT ARREARAGE PAYMENTS ARE EXCLUDED."]
[]
[]
[]
[null,"Completed By:",{"$f":"'1st Earner'!C73:E73","v":0},null,null,null,null,"Date:"]

{"sheet":"Missing Check","index":3,"n_rows":75,"n_cols":12,"rows_kept":75,"cut":false,"hidden":false,"merged":[[72,2,72,4],[72,8,72,9],[69,1,69,5],[8,0,8,1],[14,3,14,8],[18,3,18,6],[19,3,19,6],[20,3,20,6],[21,3,21,6],[26,3,26,6],[27,3,27,6],[28,3,28,6],[29,3,29,6],[34,3,34,6],[35,3,35,6],[36,3,36,6],[0,0,0,3],[1,0,1,3],[2,0,2,3],[1,4,1,9],[5,0,5,1],[5,4,5,5],[12,1,12,6],[6,4,6,5],[37,3,37,6],[42,3,42,6],[43,3,43,6],[53,3,53,6],[44,3,44,6],[45,3,45,6],[50,3,50,6],[51,3,51,6],[52,3,52,6]]}
["State Of Kansas",null,null,null,null,null,null,null,null,null,null,{"$f":"'1st Earner'!L2","v":"2018-01-24"}]
["Department for Children and Families",null,null,null,"MISSING CHECK(S) WORKSHEET"]
["Economic And Employment Services"]
[]
[]
["Case Name"]
[null,null,"(Last)","(First)","(Case#)"]
[null,null,null,null,null,null,null,"Initial",null,"Review"]
["Benefit Month"]
[null,null,"(Month)",null,"(Year)",null,null,"IR",null,"Change"]
[]
[]
[]
[]
[null,null,null,"CALCULATE MISSING CHECK(S) BY USING YEAR-TO-DATE"]
[]
[]
[]
[null,null,null,"1ST MISSING CHECK",null,null,null,"CHECK DATE","AMOUNT"]
[null,null,null,"1. Enter the most recent week YTD gross earning"]
[null,null,null,"2. Enter the most recent week gross earning"]
[null,null,null,"3. Enter YTD gross earning of the previous check"]
[null,null,null,null,null,null,null,null,{"$f":"I20-(I21+I22)","v":0}]
[]
[]
[]
[null,null,null,"2ND MISSING CHECK",null,null,null,"CHECK DATE","AMOUNT"]
[null,null,null,"1. Enter the most recent week YTD gross earning"]
[null,null,null,"2. Enter the most recent week gross earning"]
[null,null,null,"3. Enter YTD gross earning of the previous check"]
[null,null,null,null,null,null,null,null,{"$f":"I28-(I29+I30)","v":0}]
[]
[]
[]
[null,null,null,"3RD MISSING CHECK",null,null,null,"CHECK DATE","AMOUNT"]
[null,null,null,"1. Enter the most recent week YTD gross earning"]
[null,null,null,"2. Enter the most recent week gross earning"]
[null,null,null,"3. Enter YTD gross earning of the previous check"]
[null,null,null,null,null,null,null,null,{"$f":"I36-(I37+I38)","v":0}]
[]
[]
[]
[null,null,null,"4TH MISSING CHECK",null,null,null,"CHECK DATE","AMOUNT"]
[null,null,null,"1. Enter the most recent week YTD gross earning"]
[null,null,null,"2. Enter the most recent week gross earning"]
[null,null,null,"3. Enter YTD gross earning of the previous check"]
[null,null,null,null,null,null,null,null,{"$f":"I44-(I45+I46)","v":0}]
[]
[]
[]
[null,null,null,"5TH MISSING CHECK",null,null,null,"CHECK DATE","AMOUNT"]
[null,null,null,"1. Enter the most recent week YTD gross earning"]
[null,null,null,"2. Enter the most recent week gross earning"]
[null,null,null,"3. Enter YTD gross earning of the previous check"]
[null,null,null,null,null,null,null,null,{"$f":"I52-(I53+I54)","v":0}]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"Completed By:",null,null,null,null,null,"Date:"]
[]
[null,null,null,null,null,null,null,null,null,"W-3"]

{"sheet":"Pre-Authorization","index":4,"n_rows":58,"n_cols":8,"rows_kept":58,"cut":false,"hidden":true,"merged":[[0,3,0,7],[43,1,43,8],[5,3,5,5],[17,5,17,7],[19,5,19,7],[21,5,21,7],[23,5,23,7],[25,5,25,7],[31,5,31,7],[31,1,31,2],[33,1,33,2],[35,1,35,2],[37,1,37,2],[39,1,39,2],[33,5,33,7],[35,5,35,7],[37,5,37,7],[39,5,39,7],[19,1,19,2],[21,1,21,2],[23,1,23,2],[25,1,25,2],[7,1,7,2],[8,5,8,6],[10,3,10,5],[10,7,10,8],[17,1,17,2]]}
[null,null,null,"PRE-AUTHORIZATION CHECKLIST"]
[null,null,null,null,"Household Size Is 3 or 4 and $400 or More Issuance With"]
[null,null,null,null,"Child Support More Than $400 and/or"]
[null,null,null,null,"Earned Income More Than $400.01"]
[]
[null,"Specialist Name:",null,{"$f":"'1st Earner'!C73","v":0}]
[]
[null,"Case Name",null,{"$f":"'1st Earner'!C6","v":0},{"$f":"'1st Earner'!D6","v":0},{"$f":"'1st Earner'!E6","v":0}]
[null,null,null,"(Last)","(First)","(Case#)"]
[]
[null,"Reviewer:",null,null,null,null,"Date:",{"$f":"TODAY()","v":"2018-06-28"}]
[]
[]
[]
[]
[null,"EAIN",null,"Correct","Incorrect","Notes"]
[]
[null,"Frequency"]
[]
[null,"Calc Inc Amount"]
[]
[null,"Verification"]
[]
[null,"Documentation"]
[]
[null,"KAECSES Data Entry"]
[]
[]
[]
[null,"Child Support",null,"Correct","Incorrect","Notes"]
[]
[null,"Frequency"]
[]
[null,"Calc Inc Amount"]
[]
[null,"Verification"]
[]
[null,"Documentation"]
[]
[null,"KAECSES Data Entry"]
[]
[]
[]
[null,"PRE-AUTHORIZATION CHECKLIST CAUSAL FACTORS TO BE REVIEWED"]
[]
[null,"EAIN:"]
[null,null,"Frequency - Coded correctly? (WK, BW, SM, etc.)"]
[null,null,"Calculation Income Amount - Correct checks used?  Gross not net income budgeted?"]
[null,null,"Verification - Checks provided, employer statement, collateral contact made?"]
[null,null,"Documentation - Have all actions been documented thoroughly?"]
[null,null,"Correct Data Entry on EAIN"]
[]
[null,"CHILD SUPPORT:"]
[null,null,"Frequency - Coded correctly?"]
[null,null,"Calculation Income Amount - Correct amount made?"]
[null,null,"Verification - Proper verification utilized?"]
[null,null,"Documentation - Have all actions been documented?"]
[null,null,"Correct Data Entry on UNIN"]