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25 If the parent chooses to voluntarily provide their Social Security Number, acceptable forms of verification include: • Social Security card • Tax returns for the previous year

Source: 45 CFR 98.20; 45 CFR 98.21; Miss. Code Ann. § 43-1-2(4); Miss. Code Ann. § 43-1-4 Revised: August 2025

Rule 5.3 Required Documentation

A document may be used as proof that a parent meets more than one of the eligibility requirements and need not be submitted more than once. The following is a list of acceptable proof for each requirement:

1. Proof of Age (Child)

• Long Form Birth Certificate • Record of Live Birth for children under the age of three (3) months until birth certificate is received.

2. Proof of Income (Family)

• Eligibility is based on gross family income. Applicants must provide proof of income for the last thirty (30) days to include one (1) of the following:  Check stubs: One (1) if paid monthly – must include the most recent check stub issued; or Two (2) if paid bi-monthly – must include the last two consecutively issued check stubs; or Four (4) if paid weekly – must include the last four consecutively issued check stubs.

3. Federal 1040 Tax Form – (Total Income)

4. Schedule C Form 1040 – (Gross Income)

• Letter from the employer on company letterhead verifying employment: start date, income, rate of pay, how often applicant paid, number of hours worked, letter signed by employer. The letter must include the employer’s name, address, telephone number. The letter must be signed and notarized by an employer.

5. Paid in Cash

• A wage verification form, or a notarized letter from the employer verifying start date of employment, income, rate of pay, how often applicant paid, and number of hours worked. The letter must include the employer’s name, address, telephone number, and states that the employee is paid in cash the letter must be signed by an employer.