APPENDIX
Programs with eligibility guidelines require proof in order to establish your family’s eligibility. The following provides examples of what you may be required to prove as well as different options for providing proof.
Some programs do not require the same documents for all family members. For instance, when you apply for no cost Medi-Cal for children and pregnant women, you do not need to provide proof of property and assets (bank statements, car registration, retirement accounts).
Try to have all your documents ready before you apply to avoid delays in getting enrolled in programs.
Proof of Income
- Recent paycheck stub
(within 45 days)
- Federal Income tax return from previous year. Include Schedule C or F if self-employed.
- Profit and loss statement for most current 3 month period if self-employed
- Letter from employer on company letterhead
- Unemployment benefits statement
- Notice of Action from Social Services
- Copies of public benefits award letters or bank statement showing direct deposit
- Bank statement showing direct deposit for retirement or other benefits
- Scholarship letter showing grant award
- Self affidavit if no other options
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Verification of Citizenship
- Birth Certificate
- Passport
- Certificate or Report of Birth Abroad
- Naturalization Certificate
- Birth, baptism, tribal records, school records, or Tribal ID card from a federally recognized tribe
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Immigration Status
- Green Card
- Passport
- Employment Authorization Card
- Military Identification Card
- Discharge Certificate showing 2 years of continuous service in US Armed Forces
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Identification
- California Driver’s License
- California ID card from DMV
- Other picture ID
- Birth Certificate
- Recent utility or other bill with name and address
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Proof of Residency
- Rent, mortgage or utility receipts with name and address
- Car registration in your name
- California driver’s license or ID
- Proof of employment
(paycheck stub)
- Proof of registration at an employment agency
- Proof of child’s enrollment in school
- Proof of public assistance such as Food Stamps, WIC, etc.
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Proof of Deductions
Child and Dependent Care
- Receipt
- Letter from provider
- Canceled check
Alimony or Child Support
- Copy of court order
- Canceled check
- Paycheck showing garnishment
Housing and Utilities
- Rental agreement or rent receipt
- Mortgage statement
- Recent utility statements
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