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MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL C-410 Division of Welfare and Supportive Services GENERAL ELIGIBILITY REQUIREMENTS Medical Assistance Manual ACCEPTABLE VERIFICATION OF IDENTITY 15 Jul 01 MTL 01/15 • Certificate of Degree of Indian Blood, or other U.S. American Indian/Alaska Native tribal document if the document carries a photograph or other personal identifying information. • Identification card issued by the Federal, State or local government with the same information included on driver’s licenses. • School identification card with a photograph of the individual. • U.S. military card or draft record. • Military dependent’s identification card. • U.S. Coast Guard Merchant Mariner card. • Children who are under the age of 16 or younger may have their identity documented using other means, when the child does not have or cannot get any of the documents listed above. These include: ➢School record; ➢Clinic, doctor or hospital record; ➢Daycare or nursery school record; ➢Affidavit signed under penalty of perjury by a parent or guardian or caretaker relative attesting to the child’s identity. The affidavit can only be used after establishing that no other means of identity exist. The unavailability of the other sources must be documented in the case history. • Any combination of three or more corroborating documents to prove identity, such as marriage license, divorce decree, high school and college diploma, employer ID cards and property deeds and/or title. • Disabled individuals living in institutional care facilities may have their identity documented using an affidavit signed by a director or administrator where the individual resides. C-415 VERIFICATION OF COLLECTIVE NATURALIZATION If the applicant cannot present one of the documents listed above, the following will establish U.S. citizenship for collectively naturalized individuals: C-415.1 Puerto Rico ● Evidence of birth in Puerto Rico on or after April 11, 1899 and the applicant’s statement they were residing in the U.S., a U.S. possession or Puerto Rico on January 13, 1941; or ● Evidence the applicant was a Puerto Rican citizen and their statement they were residing in Puerto Rico on March 1, 1917 and they did not take an oath of allegiance to Spain.