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MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL Division of Welfare and Supportive Services C-405.4 Medical Assistance Manual GENERAL ELIGIBILITY REQUIREMENTS 15 Jul 01 MTL 01/15 EVIDENCE OF U.S CITIZENSHIP OR NATIONALITY C-405.4 Evidence of U.S. Citizenship or Nationality If an applicant does not provide documentary evidence from the list of stand-alone evidence, the following must be accepted as satisfactory evidence to establish citizenship if also accompanied by an identity document. a. U.S. public birth certificate showing birth in one of the 50 States, the District of Columbia, Puerto Rico, (if born on or after January 13, 1941), Guam, the Virgin Islands of the U.S. (on or after January 17, 1917), American Samoa, Swain’s Island, or the Commonwealth of Northern Mariana Islands (after November 4, 1986). The birth record document may be issued by the State, Commonwealth, Territory, or local jurisdiction. Note: If the document shows the individual was born in Puerto Rico, the Virgin Islands of the U.S., or the CNMI before these areas became part of the U.S., the individual may be a collectively naturalized citizen. b. State of Nevada Vital Statistics Birth Details printout. 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 Marianas 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 an adoption is not final, a Statement from a State-approved adoption agency that shows the child’s name and U.S. place of birth. i. Evidence of U.S. Civil Service employment before June 1, 1976. j. U.S. Military Record showing a U.S. place of birth. k. A data match with the SAVE Program or any other process established by the Department of Homeland Security to verify that an individual is a citizen. l. Documentation that a 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 a U.S. place of birth.