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UNOFFICIAL 1714.1-4 (d) For an individual under nineteen years of age, the department shall accept documentation from a clinic, doctor, hospital, or school record, including preschool or day care records. (e) Two of the following types of documents containing consistent information that corroborate an individual’s identity, including, but not limited to, employer identification card, high school and college diploma (including high school equivalency diploma), marriage certificate, divorce decree, and property deed or title. (f) If the individual does not have any document(s) specified in subsections (c), (d) and (e), and identity is not verified under subsection (b), the individual may submit an affidavit signed, under penalty of perjury, by another person who can reasonably attest to the individual’s identity. The affidavit shall contain the individual’s name and other identifying information establishing identity, as described in subsection (c) above. The affidavit does not have to be notarized. [Eff 09/30/13] (Auth: HRS §346-14; 42 C.F.R. §435.407; 8 C.F.R. §274a.2(b)(1)(v)(B)(1)) (Imp: HRS §346-14; 42 C.F.R. §435.407; 8 C.F.R. §274a.2(b)(1)(v)(B)(1))

§17-1714.1-4 Determination of age. (a) Verification of an individual's age shall be required when age is a factor in determining eligibility for medical assistance. (b) Verification of an individual’s age through a federal or State electronic service as described in section 17-1714.1-12(b) shall be accepted in lieu of documentation required under subsections (c) and (d). (c) The department may accept documentation that establishes citizenship or immigration status or identity of an individual under subsections 17-1714.1- 31(a), (b) and (d) for purposes of establishing the age of an individual provided that such documentation reflects the date of the birth of the individual. (d) When documentary sources are not available, the statements of relatives or friends who are