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Medical Services – Appendix C, Verification of Citizenship, Alien Status and SSN Enumeration Revised (05/18) Paroled into United States for less than 1 year • USDHS Form I-94, Arrival/Departure Card with a stamp displaying a grant of parole under Section 212 (d)(5) of the INA. The I-94 may be stamped “PIP” or “HP” • USDHS Form I-765, Application for Employment Authorization, or receipt from USCIS indicating filing of application. • USDHS Form I-766, Employment Authorization Document. • USDHS Form I-512 Parole Authorization annotated with the reason parole was granted under section 8 CFR. Eligible and exempted from the 5 year bar. Temporary Resident Status • USDHS Form I-687, Application for Status as a Temporary Resident. • Any verification from the immigration authorities or other authoritative documents indicating Temporary Status. Eligible and exempted from the 5 year bar. Temporary Protected Status (TPS) • USDHS Form I-765, Application for Employment Authorization, or receipt from USCIS indicating filing of application. • USDHS Form I-766, Employment Authorization Document. • Any verification from the immigration authorities or other authoritative documents indicating Temporary Protected Status. Eligible and exempted from the 5 year bar. Employment Authorization • USDHS Form I-765, Application for Employment Authorization. • Any verification from the immigration authorities or other authoritative documents indicating Employment Authorization. Eligible and exempted from the 5 year bar. Family Unity Beneficiary • USDHS Form I-797, Notice of Action showing approval of I-817, Application for Family Unity. • USDHS Form I-765, Application for Employment Authorization, or receipt from USCIS indicating filing of application. • USDHS Form I-765, Employment Authorization Document. • Any verification from the immigration authorities or other authoritative documents indicating Family Unity status. Eligible and exempted from the 5 year bar. Deferred Enforced Departure (DED) • USDHS Form I-765, Application for Employment Authorization, or receipt from USCIS indicating filing of application. • USDHS Form I-766, Employment Authorization Document. • Any verification from the immigration authorities or other authoritative documents indicating Deferred Enforced Departure status. Eligible and exempted from the 5 year bar.