Verification Chart - Acceptable Forms

	Search for:

DSHS Home Acronyms Revisions WAC Number Index Site Map WCCC

Revised March 22, 2012

Acceptable Forms of Verification Chart

The following table is a suggested list of reliable sources of verification for each eligibility factor. Any source, including verbal, written, and email statements, can be used as long as it meets the "Criteria for Evaluating Verification".

WHAT TO VERIFY	ACCEPTABLE VERIFICATION
Alien Status (For all non-citizen AU members)	See tables in NILC Guide for documents used to verify alien status
Child Support Obligation	Court papers SEMS data Statement from custodial parent Receipt
Citizenship and Identity for Medicaid	See Citizenship and Identity Documents - Tier 1-4
Citizenship for Cash, ABD and state funded medical assistance (Only if questionable)	Birth Certificate Naturalization Papers Passport
Dependent Care Expenses	Statement from the provider Bills or receipts SSPS data
Disability	Award letter from SSA DDDS disability approval Collateral contact with SSA Collateral contact with VA Decision from disability program specialist (ABD cash)
Emergent Medical Condition	Hospital bills Statement from the provider
Household Composition	Statement from landlord Rental agreement Collateral contact
Identity (for Cash and Food)	Driver's license State ID card Birth certificate Passport School records Current Alien Registration Card Collateral Contact outside the client's household SOLQ
Incapacity	Doctor's statement Medical records Decision from disability program specialist
Income	Pay stubs Employer statement by telephone or in writing SEMS data ACES Interfaces Bank statement that shows direct deposits (many deposits show the net amount, you may need additional information that shows the gross income) Collateral contact SOLQ
Medical Expenses	Bills/Receipts Statement from the provider
Pregnancy	Medical records or statement from a licensed medical practitioner (for TANF/SFA/PWA) Client's statement that she had a positive result from a pregnancy test (for Pregnancy Medical, Family Medical, and Children's Medical only)
Residency	Rental or lease agreement Statement from landlord Mortgage papers Utility company records or bills
Resources - including those of an immigrant's sponsor	Bank statements Insurance documents Vehicle registration Stock certificates Courthouse records Property tax statement
Shelter Costs	Landlord statement Current lease Rent or mortgage receipt Utility bills Collateral contact
SSN Application	Collateral contact with SSA SSA printouts or documents Birth document that states SSN was applied for