Asset Ownership Log 510-05-65-50

(Revised 8/1/05 ML #2981)

Approval of any spousal impoverishment application, which includes an institutionalized spouse who is age 55 or older, or is likely to reach age 55 while on assistance, should include the completion of SFN 52, "Spousal Assets" (05-100-70). This spousal assets log should include all of the couple’s assets, owned jointly or individually, and must indicate who owns the property and whether the institutionalized spouse ever had ownership in the property. The institutionalized spouse is considered to have had ownership if any of the institutionalized spouse’s income or assets were ever put into the asset or used to purchase the asset.

The purpose of this log is for clarification of asset ownership for estate collection purposes. The signed form must be sent to the Economic Assistance Policy Division.