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Electronic Data Source To Be Used (Y/N) Social Security Number Citizenship Immigration Status Residency Age/DOB Pregnancy Household Composition Caretaker Relative Medicare Application for other Benefits Other Data Source Used at Application (Y/N) Data Sour ce Used at Rene wal Data Source Used Post- Enrollment (Y/N) If Used for Post- Enrollment Frequency Used (i.e., monthly, quarterly) Comments (Y/N) and/or due to a change in circumstance. Electronic Data Source To Be Used (Y/N) Social Security Number Citizenship Immigration Status Residency Age/DOB Pregnancy Household Composition Caretaker Relative Medicare Application for other Benefits Other Data Source Used at Application (Y/N) Data Sour ce Used at Rene wal Data Source Used Post- Enrollment (Y/N) If Used for Post- Enrollment Frequency Used (i.e., monthly, quarterly) Comme nts (Y/N) TALX/Work Number YES NO NO NO YES YES NO NO NO NO NO NO YES YES YES As self-attestation is accepted for most non-financial eligibility factors, this resource is not a primary resource to verify non-financial eligibility, however this resource may provide information regarding incarceration and death. This resource may be reviewed at application, renewal, and/or due to a change in circumstance. 12. PARIS* YES NO NO NO NO NO NO NO NO NO NO YES NO NO YES Quarterly Report is received quarterly. Will be used most of the time after the completion of a case. Will use for identification of duplicate participation in Medicaid and interstate TPL match. 13. Other: (Please describe additional electronic data sources in the space provided below) MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B2 - Use of Electronic Data Sources, Non-Financial 8