Benefits Confidence | Benefits Review

🏠

Your Household

Tell us who lives with you

How many people live in your household?

Tax return source: filing status + number of dependents

How many children under 18 live with you?

0

1

2

3+

Tax return source: dependent ages listed on return

Do you have a child under age 5 living in your household?

Yes

No

Important for certain programs

Is anyone in your household age 65 or older?

Yes

No

Does your household include a veteran or active duty military member?

Yes

No

💰

Your Income

The primary driver of most eligibility

Annual household income (before taxes)

Tax return source: Adjusted Gross Income (AGI) — Line 11 of Form 1040

Since filing your last return, has your income changed?

My income comes from: (select all that apply)

W-2 job (regular employer)

Self-employment or gig work

Unemployment benefits

Social Security or Disability

Not sure

Prefer not to say

Tax return source: W-2 / Schedule C / 1099s / SSA-1099

🏥

Health Coverage

One of the highest-value areas to review

Does everyone in your household have health insurance?

Yes — through an employer

Yes — Medicaid or CHIP

Yes — Marketplace / ACA plan

No — someone in my household is uninsured

Not sure

Prefer not to say

Tax return source: Marketplace coverage shown on Form 1095-A

⚡

Housing & Utilities

Screens for housing and energy assistance

What is your housing situation?

I rent

I own my home

Living with family or friends

Temporary or transitional housing

Not sure

Prefer not to say

Is your housing cost difficult to afford?

Yes

No

Prefer not to say

Do you pay your own utility bills (electric, gas, etc.)?

Yes

No

Not sure

Have you received energy assistance (LIHEAP) before?

Yes

No

Not sure

🍎

Food & Childcare

Common areas where families miss out

Do you currently receive SNAP (food stamps)?

Yes

No

Not sure

Are groceries sometimes difficult to afford?

Yes

No

Prefer not to say

Do you pay for childcare to work or attend school?

Yes

No

Prefer not to say

Tax return source: Child & Dependent Care Credit, if claimed

📋

Benefits You Already Receive

Even current recipients often qualify for more

💡This section is optional and will not limit your report. Knowing your current benefits helps us provide accurate estimates and prioritize the best programs for your unique situation.

Which of the following do you currently receive? (select all that apply)

📍

State of Residence

Get connected to your state programs

State of residence

Tax return source: address listed on your return

Email address (to receive your report)

Your BenefitsConfidence Review

Are you sure your answers are correct?

Your Benefits
Confidence Review