PLAN FOR ACHIEVING SELF SUPPORT
February 14, 1995

Name:April

SSN:

1. My work goal is: Rehabilitation Teacher with an emphasis in Teaching Visually Impaired Students.

2. I want my plan to begin: March 1, 1995
I expect to reach my goal by: March 1, 1998 *
*Note: I believe it will take 3 years to secure a position in as a Rehabilitation Teacher.
This PASS is only outlining the first 18 month period of that goal (and only
requesting approval for the first 18 months).

3. I will have the following expenses, during the first 18 months, in order to reach my goal:

Computer, memory, software, & peripheral enhancements for my remaining educational activities and my future teaching work. Required for my goal and to assist with my own visual impairment accommodations. (Note: I am already purchasing my own desktop computer) 3/1/95-9/1/96, $210.00/mo. $3,780.00/total

On Line Computer Information Services Required for information access and education. 3/1/95-9/1/96, $15.00/mo. $270.00/total

Initial Vehicle Repairs Required initial maintenance 3/1/95-9/1/96, $50.00/mo. $900.00/total

Mileage @ $.28 per mile, to cover insurance, gas, and future maintenance. Required for my educational, rehabilitation & internship activities 3/1/95-9/1/96, $120.00/mo. $2,160.00/total

Room & Board away from my principal residence for Fall 95 Internship in Colorado Springs or Denver Required for my educational degree in Teaching 3/1/95-9/1/96, $300.00/mo. $5,400.00/total

Miscellaneous home teaching supplies, filing cabinet, desk, paper, etc... Required for small business activities 3/1/95-9/1/96, $25.00/mo. $450.00/total

Work Clothing Required for small business personal appearance requirements. 3/1/95-9/1/96, $30.00/mo. $540.00/total

TOTAL 18 Months, $750.00/mo. $13,500.00/total

NOTE: The above expenses are shown evenly amortized over the first 18 months. I anticipate that the actual monthly expenses will not reflect the "even amortization" shown above but will vary based on the billing cycles and amounts associated with the specific expense. The final totals for each item are believed to be accurate estimates at this point.

4. I already have the following money or property that I will use to reach this goal: None

5. I expect to receive the following income that I will use to reach the goal:
Deemed Income from my Roommate's Income of approximately $900.00 per month.
My wages of approximately $800.00 per month and my SSDI income of
approximately $522.00 per month. I will deposit $750.00 per month in a PASS
account. Note: I will also be using the Blind Work Expense Deductions reported
separately of approximately $300.00 per month in Federal and State Withholding
Taxes and Meals consumed at work from my current temporary position at UNC.
.

6. I will keep the money I set aside under my plan in the following bank account:
A separate PASS account will be established when this plan is approved.

7. I am already working toward this goal.

8. Signature__________________________Date________

9. Individuals who helped me with this plan:
Career Advisory Team:
David Hammis, Training Specialist-University of Northern Colorado
Center for Technical Assistance & Training
800 8th Avenue
Greeley, CO 80631 1-800-682-1240, or 303-352-5395

PASS Analysis

I. Without PASS or BWE:

Income: $1700.00/ month (Note: Includes Deemed Income from Roommate)
$522.00 SSDI
TOTAL $2222.00

Expenses $30.00 Clothing
$300.00 State & Federal Withholding Taxes and Meals at Work
(Qualified BWE's)
$50.00 Vehicle Repairs
$100.00 Computer pmts of $75.00 & min. enhancements of $25.00
$50.00 Current Mileage/ ins. not including internship, or
internship R&B future costs

TOTAL $530.00

Discretionary income after the current "real" expenses which are also
"potential" PASS /BWE expenses:

($2222.00-$530.00) = $1692.00 = Discretionary Income

.....PASS Analysis continued on next page....

II. With A $750.00/month PASS & $300.00/month BWE:

Income: $1700.00/ month (Note: Includes Deemed Income from Roommate)
$522.00 SSDI
$458.00 SSI
TOTAL $2680.00
-PASS -750.00 (Note: Deposit PASS set aside in separate account)

TOTAL: $1930.00 = Discretionary Income (Note: The expenses listed in
Section I. are now included in the PASS & BWE and
do not reduce Discretionary Income)

Analysis: The $750.00 per month PASS will yield approximately $13,500.00 total for the goal described in the PASS during the 1st 18 months with a potential of generating $27,000.00 over 3 years. The Blind Work Expenses listed will yield an additional $5,400.00 over 18 months or possibly $10,800.00

Caution: If the $1700.00 per month combined earned and Deemed Income changes the PASS will be affected and require a revision to maintain a working PASS that is not detrimental financially. Since the internship predicted in the Fall of 1995 is unpaid the PASS will need to be amended at that time to adjust for the income changes.

This PASS & BWE's will also generate Medicaid Eligibility which poses the potential of significant cost savings for Medical Health Care concerns during the life of the PASS.