305.05 Verification of Citizenship SR 08-06, 10/08 (FAM-A)

Verify citizenship with acceptable forms of proof as detailed in the 4-tiered chart below.

Verify citizenship of each household member at the initial determination of eligibility. Deny financial and medical assistance to any individual who does not provide proof of citizenship status. Only the documents detailed in the 4-tiered chart below are considered acceptable forms of proof for citizenship when applying for most categories of cash or medical assistance. See the list of individuals who are exempt from these requirements below.

All citizenship and identity documents MUST BE ORIGINALS OR COPIES CERTIFIED BY THE ISSUING AGENCY. Notarized copies are not considered valid proofs.

TIER I FOR PROOF OF BOTH CITIZENSHIP AND IDENTITY

• US Passport

• Certificate of Naturalization

• Certificate of US Citizenship

TIER II FOR PROOF OF CITIZENSHIP

Documents in TIER I must be unavailable to the individual before using this level of verification. Additionally, the individual must provide one citizenship document from Column A below along with one identity document from Column B below.

TIER III FOR PROOF OF CITIZENSHIP

Citizenship documents in TIER I or TIER II must be unavailable to the individual before using this level of verification. Additionally, the individual must declare birth in the U.S. and must also provide an identity document from TIER II above.

• Hospital record on hospital letterhead, established at time of birth & 5 years prior to initial application date for assistance, showing US place of birth. Do not accept "souvenir" birth certificates from a hospital.

• Life, health, or other insurance record, created 5 years prior to initial application date for assistance, showing US place of birth.

• Official religious document, recorded with the religious organization in the US within 3 months of birth, showing US place of birth, & date of birth or individual’s age at time of recording.

• Early school records showing a US place of birth, name of child, date of admission to school, date of birth, and name(s) and place(s) of birth of applicant’s parents.

TIER IV FOR PROOF OF CITIZENSHIP

Citizenship documents from TIERS I, II, or III must be unavailable to the individual before using this level of verification. Additionally, the individual must declare birth in the U.S. and must also provide an identity document from TIER II above.

• Federal or state census record showing US Citizenship or US place of birth and age.

• One of the following documents showing a US place of birth & created at least 5 years prior to initial application date for assistance:

- Seneca Indian tribal census;

- Bureau of Indian Affairs tribal census records of Navajo Indians;

- US State Vital Statistics official notification of birth registration;

- A delayed US public birth record (recorded more than 5 yrs. after time of birth);

- Statement from the physician or midwife who was in attendance at time of birth; or

- Roll of Alaska Natives maintained by the Bureau of Indian Affairs.

• Institutional admission papers from a nursing facility, skilled care facility or other institution, showing US place of birth and created at least 5 years prior to initial application date for assistance.

• Medical (clinic, doctor or hospital) record indicating US place of birth & created at least 5 years prior to initial application date for assistance.

• Written affidavit. There must be at least 2 affidavits by separate individuals, neither of which can be related to or be the applicant or recipient. The individuals must have personal knowledge of the event(s) establishing the applicant’s or recipient’s claim of citizenship, and must be able to provide proof of their own citizenship and identity.

Exceptions to the Above Citizenship Requirements:

The following individuals are exempt from the more restrictive citizenship requirements described above and can verify citizenship with acceptable forms of proof such as birth or hospital records, voter registration cards, U.S. passport, and INS documentation which certifies citizenship or naturalization:

• individuals who are entitled to or enrolled in Medicare (Part A, Part B, or Part D, for example);

• individuals who receive SSI, verified via the SDX;

• individuals who receive SSDI;

• children or pregnant women determined to be presumptively eligible for medical assistance;

• individuals eligible for Healthy Kids Silver;

• newborn infants born to women who are Medicaid recipients, for 1 year from their date of birth, as long as the child remains a member of the mother’s household and the mother continues to reside in NH, regardless of the mother’s immigration status. This group includes children whose births were covered by Emergency Medicaid for Non-Citizens; and

• children receiving either Title IV-B services or Title IV-E adoption or foster care payments.

Do not require verification of citizenship of a Healthy Kids-Silver (HKS) child if the parent declares that a child is a US citizen on the application. However, if the parent voluntarily furnishes documentation of the child’s citizenship, e.g., by providing a birth certificate to verify the child’s age, accept it. If the parent declares that the child is not a citizen, require documentation to verify the child’s alien status in accordance with this Chapter.