Sample Documents to Prove Citizenship, Immigration Status, and Identity on the Marketplace
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1 Sample Documents to Prove Citizenship, Immigration Status, and Identity on the Marketplace Community Health Association of Mountain/Plains States (CHAMPS) Created July 2015 Documents Accepted for Proving U.S. Citizenship Documents Accepted for Proving Immigration Status Documents Accepted for Proving Identity
2 Documents Accepted for Proving U.S. Citizenship U.S. Passport
3 Certificate of Citizenship (N-560/N-561) Certificate of Naturalization (N-550/N-570)
4 Tribal Enrollment/Identification Card
5 Certificate Degree of Indian Blood Not Pictured: Tribal Census Document Documents on Tribal letterhead signed by a Tribal official
6 If the consumer does not have any of the documents above, they can provide one document from each of the following lists to prove citizenship: Any one of these documents: U.S. Public Birth Certificate
7 Consular Report of Birth Abroad (FS-240, CRBA) Certification of Report of Birth (DS-1350)
8 Certification of Birth Abroad (FS-545) U.S. Citizen Identification Card (I-197 or I=179)
9 Final adoption decree showing the person s name and U.S. place of birth Not pictured: Northern Mariana Card (I-873) U.S. Civil Service Employment Record showing employment before June 1, 1976 Military record showing a U.S. place of birth U.S. medical record from a clinic, hospital, physician, midwife or institution showing a U.S. place of birth U.S. life, health or other insurance record showing U.S. place of birth Religious record showing U.S. place of birth recorded in the U.S. School record showing the child s name and U.S. place of birth Federal or State census record showing U.S. citizenship or U.S. place of birth Documentation of a foreign-born adopted child who received automatic U.S. citizenship (IR3 or IH3)
10 AND any one of these documents (must have a photograph or other information like name, age, race, weight, height, etc.): Driver s License or ID Card
11 School Identification Card U.S. military card or draft record or Military dependent s identification card U.S. Military Card:
12 Draft Record: Military dependent s identification card: U.S. Coast Guard Merchant Mariner card
13 Voter Registration Card *Voter registration card design will vary significantly by state. Not Pictured: A clinic, doctor, hospital, or school record, including preschool or day care records (for children under 19 years old) Two documents containing consistent information that proves your identity, like employer IDs, high school and college diplomas, marriage certificates, divorce decrees, property deeds, or titles
14 Documents Accepted for Proving Immigration Status Reentry Permit (I-327) Consumers need to enter their alien registration number (USCIS or file number) from this document.
15 Permanent Resident Card ( Green Card ) (I-551) Consumers need to enter their alien number (also called alien registration or USCIS number) and card number (also called receipt number) from the document. If an alien number isn t available, consumers may select Other as the document type and provide a description of the document.
16 Refugee Travel Document (I-571) Consumers need to enter their alien registration number (USCIS number) from this document. Machine Readable Immigrant Visa with Temporary I-551 Language Temporary language is located in small print underneath the picture. Consumers need to enter their alien registration number (USCIS number) from this document). I-551 Stamp on passport or I-94/I-94A
17 Foreign Passport Consumers need to enter their passport number, expiration date, and country of issuance from this document. Arrival/Departure Record (I-94/I-94A) Consumers need to enter their I-94 number from this document.
18 Certificate of Eligibility for Nonimmigrant Student Status (I-20) Consumers need to enter their Student & Exchange Visitor Information System (SEVIS) ID from this document. Certificate of Eligibility for Exchange Visitor Status (DS-2019) Consumers need to enter their Student & Exchange Visitor Information System (SEVIS) ID from this document.
19 Employment Authorization Card (I-766) Consumers need to enter their alien registration number (USCIS number), card number, expiration date, and category code from this document.
20 Notice of Action (I-767) Consumers need to enter their alien registration number (USCIS number) or I-94 number from this document. Not Pictured: Certification from U.S. Department of Health and Human Services (HHS) Office of Refugee Resettlement (ORR) Document indicating withholding of removal (or withholding of deportation) Administrative order staying removal issued by the U.S. Department of Homeland Security (DHS) Document indicating a member of a federally-recognized Indian tribe or American Indian born in Canada Office of Refugee Resettlement (ORR) eligibility letter (if under 18) Resident of American Samoa Card
21 Documents Accepted for Proving Identity Driver s License or ID Card issued by state or territory School identification card Voter registration card Identification card used by the federal, state, or local government U.S. Passport Certificate of Naturalization (form N-550 or N-570) or Certificate of U.S. Citizenship (Form N-560 or N-561) Permanent Resident Card or Alien Registration Receipt Card (Form I-551) Employment Authorization Document that contains a photograph (Form I-766) Military dependent s identification card Native American tribal document U.S. Coast Guard Merchant Mariner card Foreign passport, or identification card issued by a foreign embassy or consulate that contains a photograph If you can t provide a copy of one of the documents above, you can submit copies of two of the following documents to the Marketplace: Birth certificate Social Security Card
22 Marriage Certificate Not Pictured: Divorce decree Employer identification card High school or college diploma Property deed or title
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