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Eligibility Factor Self- Attestation Accepted without Additional Verification (Y/N) Self- Attestation Accepted with Post-Eligibility Verification (Y/N) Electronic Data Source Used (Y/N) Reasonable Compatibility Standard Used Specify Reasonable Compatibility Standard for Income Ask for a Reasonable Explanation from the Individual (Y/N) Paper Documentation Required from the Individual (Y/N) Comments Household Composition YES NO NO No individual applying for benefits as a member of this household is receiving benefits or child support at another address or as part of another household. Only two individuals claiming parent status for one child, and only one unless both live at same address; caretaker relative status only if no one is claiming parent status for the same child. N/A YES YES Self-attestation will be accepted unless available data from previous applications or other existing cases is not reasonably compatible with the attestation. In such cases, Ohio will ask for a reasonable explanation, additional information, or manual documentation if necessary. For attestation of multiple fetus resulting in a larger household size, medical verification of fetus count is required. Pregnancy *** YES NO NO Individual is not male; is not under age 9, or age 65 or older; and is not attesting to same pregnancy for longer than 10 months. N/A YES YES As required by federal guidance, self-attestation will be accepted unless information on the application or available data conflicts with the attestation. In such cases, we will ask for a reasonable explanation or paper documentation if necessary. Caretaker Relative YES NO NO No individual applying for benefits as a member of this household is receiving benefits or child support at another address or as part of another household. Only two individuals claiming parent status, and only one unless both live at same address; caretaker relative status only if no one is claiming parent status for the same child; no two individuals (unless they are married) claiming to be caretaker relative of the same child. N/A YES YES Self-attestation will be accepted unless available data from previous applications or other existing cases is not reasonably compatible with the attestation. In such cases, Ohio will ask for a reasonable explanation, additional information, or manual documentation if necessary. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 2