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A. Eligibility, Determination, and Documentation

1. Application Process a. The State agency requires all local agencies to use a standardized application process for all persons applying for the WIC Program ☒ Yes ☐ No

b. The State agency shares ☐ Statewide or ☐ at local agency (check one), a common income application or certification form with (check all that apply): ☒ No other benefit programs ☐ Medicaid ☐ TANF ☐ SNAP ☐ Maternal and Child Health (MCH) ☐ Other reduced-price health care program(s) ☐Other (specify): Click or tap here to enter text. ADDITIONAL DETAIL: Certification and Eligibility Appendix and/or Procedure Manual (citation): Click or tap here to enter text.

2. Residency, Identity and Physical Presence Requirements a. The State agency requires documentation of residency ☒ Yes ☒ Signed statement that documentation of residency information is not available and why (e.g., homeless, theft, fire) ☐No (Specify why, e.g., ITOs and Alaska natives who are exempt from this requirement): Click or tap here to enter text. b. The State agency has reciprocal agreements concerning residency with other State agencies ☐ Yes; list States: Click or tap here to enter text. ☒ No Describe any reciprocal agreements: Click or tap here to enter text.

c. The State agency has special residency policies and procedures for how the following special categories should be treated (check all that apply): ☒ Homeless applicants ☒ Institutionalized applicants ☒ Migrants ☐ Indian Tribal Organizations