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Andrew Moser, Assistant Secretary - page 4 / 8

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DOCUMENTATION SOURCES

ELIGIBILITY CRITERIA

ACCEPTABLE DOCUMENTATION (Only one of the following is required)

SOCIAL SECURITY NUMBER

DD-214, Report of Transfer or Discharge

Driver's License

Employment Records

IRS Form Letter 1722 (See Appendix A)

Letter from Social Services Agency

Pay Stub

Social Security Administration NUMI Printout (See Appendix A)

Social Security Benefits

Social Security Card

W-2 Form

CITIZENSHIP/ALIEN STATUS

Alien Registration Card indicating Right to Work (INS Forms

I-151, I-551, I-94, I-688A, I-197, I-179)

Baptismal Certificate (If Place of Birth is Shown)

Birth Certificate

DD-214, Report of Transfer or Discharge (If Place of Birth is Shown)

Food Stamp Records

Foreign Passport Stamped Eligible to Work

Hospital Record of Birth

Naturalization Certification

Public Assistance Records

Social Security Administration NUMI Printout (See Appendix A)

U.S. Passport

Voter Registration Card

SELECTIVE SERVICE

REGISTRANT

Acknowledgment Letter

Contact the Selective Service at 708-688-6888

DD-214, Report of Transfer or Discharge

SDA/State Registration Process

Selective Service Advisory Opinion Letter

Selective Service Registration Card

Selective Service Registration Record (Form 3A)

Selective Service Verification Form

Stamped Post Office Receipt of Registration

BIRTHDATE/AGE

Baptismal Record

Birth Certificate

DD-214, Report of Transfer or Discharge Paper

Driver's License

Federal, State or Local Government Identification Card

Hospital Record of Birth

Passport

Public Assistance/Social Service Records

School Records/Identification Card

Social Security Administration NUMI Printout (See Appendix A)

Work Permit

CASH PUBLIC ASSISTANCE

NOTE: The listed items of

documentation are acceptable for

any individual listed on the grant.

Copy of Authorization to Receive Cash Public Assistance

Copy of Public Assistance Check

Medical Card Showing Cash Grant Status

Public Assistance Identification Card Showing Cash Grant Status

Public Assistance Records/Printout

Refugee Assistance Records

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