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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 Applicatio n (Y/N) Data Source Used at Renewal (Y/N) Data Source Used Post- Enrollme nt (Y/N) If Used for Post- Enrollment Frequency Used (i.e. monthly, quarterly) Comments 4. Department of Motor Vehicles (DMV) YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO Uses data source if the state is made aware of conflicting information related to residency that needs to be resolved. 5. Temporary Assistance for Needy Families (TANF) NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO 6. Supplemental Nutrition Assistance Program (SNAP) NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO 7. Office of Child Support Enforcement YES NO NO NO NO NO NO NO NO NO NO NO YES YES NO Uses data source if the state is made aware of conflicting information related to caretaker relative that needs to be resolved. 8. State General Assistance Programs NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO 9. Women, Infants and Children Program (WIC) NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO 10. State Income Tax NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B2 - Use of Electronic Data Sources, Non-Financial 7