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Verification Chart - Acceptable Forms

Revised November 19, 2007

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, GA-U 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 Collateral contact with SSA Collateral contact with VA 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 Incapacity Doctor's statement Medical records Decision from Incapacity Specialist (for GAU) 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 Statement from licensed medical practitioner Client's statement that she had a positive result from a pregnancy test Medical records 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

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Modification Date: November 19, 2007

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