Person Composite Service (PCS) Age/Date of Birth SVES BENDEX Birth Certificate Federal Hub Driver’s License Person Composite Service (PCS) Lawful Presence SAVE Status, Lawful Federal Hub Permanent Resident) Person Composite USCIS Document Service (PCS) SVES (40 Work Quarters) Residency Client Statement Out-of-State Benefits Client Statement Marital Status Client Statement Relationship Client Statement Household Composition/ Client Statement Tax Filing Status If total reported income is under $300, the client’s statement is accepted as verification Unearned Income BENDEX Collateral Call SDX Award Letter UCB Check Stub Retirement System DHHS Verification Forms Earned Wage Match Collateral Call Person Composite Check Stub Service (PCS) Wage Income DHHS Form 1245 or other Verification written statement from VerifyDirect employer CHIP Self-Employment Tax Return Contributions Client Statement Pregnancy Client Statement (Pregnant Woman) School Attendance Specific (If the only Qualifying Client Statement Child for a PCR is Age 18) Disability BENDEX SSA/SSI Award Letter (Non-MAGI with Applicant SDX MAO99 Category under age 65) Electronic Source Client Statement Hard Copy 105.01.02 Resource Verification Matrix (Eff. 09/01/16) Acceptable Sources Only consider resources for non-MAGI programs Resource Verification Sources Instruction
Person Composite Service (PCS) Age/Date of Birth SVES BENDEX Federal Hub Person Composite Service (PCS) Birth Certificate Driver’s License Lawful Presence Status, Lawful Permanent Resident) SAVE Federal Hub Person Composite Service (PCS) SVES (40 Work Quarters) USCIS Document Residency Client Statement Out-of-State Benefits Client Statement Marital Status Client Statement Relationship Client Statement Household Composition/ Tax Filing Status Client Statement Income If total reported income is under $300, the client’s statement is accepted as verification Unearned Income BENDEX SDX UCB Retirement System Collateral Call Award Letter Check Stub DHHS Verification Forms Earned Wage Match Person Composite Service (PCS) Wage Verification VerifyDirect CHIP Collateral Call Check Stub DHHS Form 1245 or other written statement from employer Self-Employment Tax Return Contributions Client Statement Category Specific Pregnancy (Pregnant Woman) Client Statement School Attendance (If the only Qualifying Child for a PCR is Age 18) Client Statement Disability (Non-MAGI with Applicant under age 65) BENDEX SDX SSA/SSI Award Letter MAO99 Electronic Source Client Statement Hard Copy 105.01.02 Resource Verification Matrix (Eff. 09/01/16) Acceptable Sources Only consider resources for non-MAGI programs Resource Verification Sources Instruction
Chapter_105.docx