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130 CMR: DIVISION OF MEDICAL ASSISTANCE

Trans. by E.L. 240 Rev. 08/19/22 MASSHEALTH CITIZENSHIP AND IMMIGRATION Chapter 518 Page 518.005 (3 of 4)

(l) documentation that the child meets the requirements of section 101 of the Child Citizenship Act of 2000 (8 U.S.C. § 1431); (m) medical records, including, but not limited to, hospital, clinic, or doctor records or admission papers from a nursing facility, skilled-care facility, or other institution that indicate place of birth; (n) life, health, or other insurance records that indicate a U.S. place of birth; (o) official religious records recorded in the U.S. showing that the birth occurred in the U.S.; (p) school records, including preschool, Head Start, and day care, showing the child’s name and U.S. place of birth; (q) federal or state census records showing U.S. citizenship or a U.S. place of birth; and (r) if an individual does not have one of the documents listed in 130 CMR 518.005(A)(2)(a) through (q), he or she may submit an affidavit signed by another individual, under penalty of perjury, who can reasonably attest to the individual’s citizenship, and that contains the individual’s name, date of birth, and place of U.S. birth. The affidavit does not have to be notarized. (3) Acceptable Proof of Identity. (a) The following are acceptable proof of identity, provided such documentation has a photograph or other identifying information including, but not limited to, name, age, sex, race, height, weight, eye color, or address. 1. identity documents listed at 8 CFR 274a.2(b)(1)(v)(B)(1), except a driver’s license issued by a Canadian government authority; 2. driver’s license issued by a state or territory; 3. school identification card; 4. U.S. military card or draft record; 5. identification card issued by the federal, state, or local government; 6. military dependent’s identification card; or 7. U.S. Coast Guard Merchant Mariner card; (b) for children younger than 19 years old, a clinic, doctor, hospital, or school record, including preschool or day care records; (c) two documents containing consistent information that corroborates an applicant’s identity. Such documents include, but are not limited to 1. employer identification cards; 2. high school and college diplomas (including high school equivalency diplomas); 3. marriage certificates; 4. divorce decrees; 5. property deeds or titles;