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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 (2 of 4)

(c) Certificate of U.S. Citizenship; (d) a document issued by a federally recognized Indian tribe, as published in the Federal Register by the Bureau of Indian Affairs within the U.S. Department of the Interior, and identifies the federally recognized Indian tribe that issued the document, identifies the individual by name, and confirms the individual’s membership, enrollment, or affiliation with the tribe. These documents include, but are not limited to, a tribal enrollment card, a Certificate of Degree of Indian Blood, a tribal census document, and documents on tribal letterhead, issued under the signature of the appropriate tribal official that meet the requirements of 130 CMR 518.005(A)(1)(d). (2) Acceptable Proof of Citizenship. If one of the documents listed in 130 CMR 518.005(A)(1) is not provided, the following documents are acceptable as satisfactory evidence to establish citizenship if also accompanied by an identity document listed in 130 CMR 518.005(A)(3): (a) U.S. public birth certificate showing birth in one of the 50 states (including the District of Columbia, Puerto Rico (if born on or after January 13, 1941), Guam, the U.S. Virgin Islands (if born on or after January 17, 1917), American Samoa, Swain’s Island, or the CNMI (if born after November 4, 1986, CNMI local time). The birth record may be issued by the state, commonwealth, territory, or local jurisdiction. However, if the document shows the individual was born in Puerto Rico, the U.S. Virgin Islands, or the CNMI before these areas became part of the U.S., the individual may be a collectively naturalized citizen; (b) cross-match with the Massachusetts Registry of Vital Statistics that documents a record of birth; (c) Certification of Report of Birth, issued to U.S. citizens who were born outside the U.S.; (d) Report of Birth Abroad of a U.S. Citizen; (e) certification of birth; (f) U.S. Citizen I.D. card; (g) Northern Mariana Identification Card, issued to a collectively naturalized citizen who was born in the CNMI before November 4, 1986; (h) final adoption decree showing the child’s name and U.S. place of birth, or, if the adoption is not final, a statement from state-approved adoption agency that shows the child’s name and U.S. place of birth; (i) evidence of U.S. civil service employment prior to June 1, 1976; (j) U.S. military record showing a U.S. place of birth; (k) data match with the Systematic Alien Verification for Entitlements (SAVE) Program or any other process established by the DHS to verify that an individual is a citizen;