Verification Chart - Acceptable Forms
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Verification Chart - Acceptable Forms


Revised July 21, 2014


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
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
LAM (Living Above Means)
  • Alternate Income Verification
  • Bills/Receipts
  • Collateral contact
  • Bank Statement
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
Modification Date: July 21, 2014