"Section 3 Income Worksheet" - Town of Ashland, Maine

Section 3 Income Worksheet is a legal document that was released by the Maine Department of Economic & Community Development - a government authority operating within Maine. The form may be used strictly within Town of Ashland.

Form Details:

  • Released on October 6, 2020;
  • The latest edition currently provided by the Maine Department of Economic & Community Development;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Maine Department of Economic & Community Development.

ADVERTISEMENT
ADVERTISEMENT

Download "Section 3 Income Worksheet" - Town of Ashland, Maine

169 times
Rate (4.7 / 5) 12 votes
DEPARTMENT OF ECONOMIC & COMMUNITY DEVELOPMENT
COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM
SECTION 3 INCOME WORKSHEET
TOWN OF ASHLAND
To be completed by all employees working on the site where the construction work is taking place.
Completion of this worksheet is solely to determine if there is utilization of Section 3 employees on this
construction project and should not be considered as a condition of employment.
Please place an "X" in the appropriate spaces pertaining to your family's size, and your income.
FOR EXISTING EMPLOYEES: If you were hired within the last five years please use your income
PRIOR to the date of hire.
FAMILY SIZE:
INCOME:
(Please check one)
(Please Circle one)
30%
50%
80%
Above 80%
____ 23,601 – 37,700
1
____ Below 14,150
____ 14,151 - 23,600
____ Above 37,701
____ 17,241 – 26,950
____ 26,951 – 43,100
2
____ Below 17,240
____ Above 43,101
____ 21,721 – 30,300
____ 30,301 – 48,500
3
____ Below 21,720
____ Above 48,501
____ 33,651 – 53,850
4
____ Below 26,200
____ 26,201 - 33,650
____ Above 53,851
5
____ Below 30,680
____ 30,681 - 36,350
____ 36,351 - 58,200 ____ Above 58,201
6
____ Below 35,160*
____ Below 39,050
____ 39,051 - 62,500 ____ Above 62,501
7
____ Below 39,640*
____ Below 41,750
____ 41,751 - 66,800 ____ Above 66,801
8
____ Below 44,120*
____ Below 44,450
____ 44,451 - 71,100 ____ Above 71,101
*Read This Carefully*
In determining total family income use your Total Adjusted Gross income for your household as reported on your Federal
Income Tax form.
If you use Form 1040 – use line 37
If you use Form 1040A – use line 21
If you use Form 1040EZ – use line 4
FOR USE BY PRIME CONTRACTOR ONLY
Name of Prime Contractor: ___________________________________________________________________
Project Name: _____________________________________________________________________________
____ Yes _____ No
Is the employee Section 3 eligible?
If yes, must be included in SECTION 3 UTILIZATION REPORT.
____________________________
Job Title or Construction Trade that Employee is hired for
REV10/6/20
Effective 7/14/14
DEPARTMENT OF ECONOMIC & COMMUNITY DEVELOPMENT
COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM
SECTION 3 INCOME WORKSHEET
TOWN OF ASHLAND
To be completed by all employees working on the site where the construction work is taking place.
Completion of this worksheet is solely to determine if there is utilization of Section 3 employees on this
construction project and should not be considered as a condition of employment.
Please place an "X" in the appropriate spaces pertaining to your family's size, and your income.
FOR EXISTING EMPLOYEES: If you were hired within the last five years please use your income
PRIOR to the date of hire.
FAMILY SIZE:
INCOME:
(Please check one)
(Please Circle one)
30%
50%
80%
Above 80%
____ 23,601 – 37,700
1
____ Below 14,150
____ 14,151 - 23,600
____ Above 37,701
____ 17,241 – 26,950
____ 26,951 – 43,100
2
____ Below 17,240
____ Above 43,101
____ 21,721 – 30,300
____ 30,301 – 48,500
3
____ Below 21,720
____ Above 48,501
____ 33,651 – 53,850
4
____ Below 26,200
____ 26,201 - 33,650
____ Above 53,851
5
____ Below 30,680
____ 30,681 - 36,350
____ 36,351 - 58,200 ____ Above 58,201
6
____ Below 35,160*
____ Below 39,050
____ 39,051 - 62,500 ____ Above 62,501
7
____ Below 39,640*
____ Below 41,750
____ 41,751 - 66,800 ____ Above 66,801
8
____ Below 44,120*
____ Below 44,450
____ 44,451 - 71,100 ____ Above 71,101
*Read This Carefully*
In determining total family income use your Total Adjusted Gross income for your household as reported on your Federal
Income Tax form.
If you use Form 1040 – use line 37
If you use Form 1040A – use line 21
If you use Form 1040EZ – use line 4
FOR USE BY PRIME CONTRACTOR ONLY
Name of Prime Contractor: ___________________________________________________________________
Project Name: _____________________________________________________________________________
____ Yes _____ No
Is the employee Section 3 eligible?
If yes, must be included in SECTION 3 UTILIZATION REPORT.
____________________________
Job Title or Construction Trade that Employee is hired for
REV10/6/20
Effective 7/14/14