CATEGORIES OF LAWFUL PRESENCE ACCEPTABLE DOCUMENTATION
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1 Category of Lawful Presence and Acceptable Documents* Lawful Permanent Resident (LPR/Green Card holder) Permanent Resident Card, Green Card (I-551) Temporary I-551 Stamp (on passport or I-94/I-94A)(unexpired) Machine Readable Immigrant Visa (with temporary I-551 language)(unexpired) Reentry Permit (I-327) Arrival/Departure Record (I-94) (showing stamp for admission as LPR) or Arrival/Departure Record (I-94) in foreign passport (showing stamp for admission as LPR) Order issued by DHS, BIA, immigration judge granting registry, suspension of deportation, cancellation of removal, or adjustment of status Receipt from USCIS showing that I-90 app for LPR replacement card filed Applicant to LPR status (aka adjustment to LPR status) Notice of Action (I-797) (ASC Appointment notice with Case Type I-485 Application, Receipt for Application for Employment Authorization based on C9 ) Employment Authorization Document (Card) (I-766) (e.g. annotated C9 or C9P ) Employment Authorization and Advance Parole Card (I-512)(authorization for parole, indicating applicant for adjustment of status) Receipt showing filing or pending status of Form I-485 Application to Register Permanent Residence or Adjust Status Refugee Arrival/Departure Record (I-94/I-94A) (stamped Refugee or 207 ) Employment Authorization Document (Card) (I-766) (annotated A3 ) Refugee Travel Document (I-571) Permanent Resident Card, Green Card (I-551) (may be annotated RE6, RE7, RE8, or RE9 ) NOTE: the annotation reveals status prior to adjustment to LPR which matters only for exemption from the 5-year bar for refugees. Application for Employment Authorization (I-765), or receipt from USCIS indicating filing of application. COVERED CALIFORNIA TM 1
2 Category of Lawful Presence and Acceptable Documents* Conditional Entrant Granted before 1980 (NOTE: this is the immigration status used for refugees prior to the Refugee Act of 1980; most have adjusted to LPRs though some retain CE status.) Arrival/Departure Record (I-94/I-94A) (indicating status as conditional entrant, refugee-conditional entrant Seventh Preference, 203(a)(7) or P7 )Employment Authorization Document (Card) (I-766) (annotated A3 ) Permanent Resident Card, Green Card (I-551) (may be annotated R86 ) NOTE: the annotation reveals status prior to adjustment to LPR which matters only for exemption from the 5-year bar for conditional entrants. Asylee Arrival/Departure Record ( I-94/I-94A)(with stamp showing grant of asylum, Asylee or 208 ) Arrival/Departure Record in foreign passport (I-94/I-94A) (with stamp showing grant of asylum, Asylee or 208 ) Order granting asylum by USCIS, DHS, immigration judge, BIA or federal court Employment Authorization Document (Card) (I-766) (annotated A5 ) Refugee Travel Document (I-571) Permanent Resident Card, Green Card (I-551)(annotated AS1, AS2, AS3, AS4, AS5, AS6, AS7 AS8, GA6, GA7, GA8 ) *NOTE: the I-551 annotation reveals status prior to adjustment to LPR which matters only for exemption from the 5-year bar for asylees. Granted Withholding of Deportation or Withholding of Removal (under the immigration laws or under the Convention Against Torture (CAT)) Document indicating withholding of removal (e.g. order granting withholding of deportation/removal issued by USCIS, DHS, immigration judge, BIA or federal court) Employment Authorization Document (Card) (I-766) (annotated A10 ) Administrative order staying removal issued by the Department of Homeland Security Arrival/Departure Record (I-94/I-94A)(stamped Withholding of Deportation, 243(h) or 241(b)(3) ) Refugee Travel Document (I-571) COVERED CALIFORNIA TM 2
3 Applicant for Asylum or Withholding of Deportation/Removal, including applicants under CAT Employment Authorization Document (Card) (I-766) (annotated C8 ) Receipt or notice showing filing or pending status of Application for Asylum and Withholding (I-589) IMPORTANT: Only those applicants for Asylum or Withholding of Deportation or Withholding of Removal who have been granted Employment Authorization if over the age of 14, or are under the age of 14 and have an application pending for at least 180 days are eligible. Cuban or Haitian Entrant Arrival/Departure Record (I-94/I-94A) (with stamp indicating Cuban/Haitian Entrant or any other notation indicating parole under 212(d)(5), including CU6, CU7, or CH6, among others rare since 1980s) Employment Authorization Document (Card) (I-766) (annotated C8, or C11 ) Temporary I-551 Stamp (on passport or I-94/I-94A) (unexpired) Permanent Resident Card, Green Card (I-551)(annotated CU6, CU7, CU8 ) *NOTE: An I-551 annotation reveals status prior to adjustment to LPR which matters only for exemption from the 5-year bar for Cuban/Haitian Entrants. Receipt or notice showing filing or pending status of Application for Asylum and withholding (I-589) Paroled into the U.S. (for less than one year) Arrival/Departure Record (I-94/I-94A) (with stamp indicating parole or PIP or 212(d)(5) or other language indicating parole status) Employment Authorization Document (Card) (I-766)(annotated A4 or C11 ) Employment Authorization and Advance Parole Card (I-512)(annotated with reason parole was granted under Title 8 of the Code of Federal Regulations) Permanent Resident Card, Green Card (I-551)(if individual has since adjusted to LPR status) COVERED CALIFORNIA TM 3
4 Temporary Protected Status (TPS) Employment Authorization Document (Card) (I-766)(annotated A12 ) Notice of Action (I-797) (showing grant of TPS status) Applicant for TPS with Employment Authorization Receipt or notice showing filing or pending status of Application for Temporary Protected Status (I-821) Employment Authorization Document (Card) (I-766)(annotated C19 ) Granted Deferred Enforced Departure (DED) Employment Authorization Document (Card)(I-766)(annotated A11 ) Granted Deferred Action Status Notice of Action (I-797) (showing approval of deferred action status) Employment Authorization Document (Card)(I-766) (annotated C14 ) IMPORTANT: Deferred Action for Childhood Arrivals is not an eligible immigration status for applying for health insurance. The Employment Authorization Document (I-766) annotated Category C33 is specific to DACA and is not proof of eligibility for Covered California. Applicant for Special Immigrant Juvenile Status (SIJS) Notice of Action (I-797) ( Special Immigrant Juvenile Approval Notice, Welcome Notice/Approval of I-485, Other Basis of Adjustment SL6 ) Permanent Resident Card, Green Card (I-551) (coded SL6 ) COVERED CALIFORNIA TM 4
5 Qualified Domestic Violence Survivor : pending petition under Violence Against Women Act (VAWA) or approval Notice of Action (I-797) (referencing a pending I-360 ) Employment Authorization Document (Card) (I-766)(annotated A10, C14, C9, C10, C14 or C31 ) Receipt or other proof of filing I-485 Application to Register Permanent Residence or Adjust Status Any documents indicating a pending suspension of Deportation or cancellation of removal case, including a receipt from an immigration court indicating filing of Application for Suspension of Deportation (EOIR-40) or Application for Cancellation of Removal (EOIR-42) Receipt or other proof of filing I-130 visa petition under immediate relative (IR) or 2 nd family preference (P-2) showing status as a spouse or child Application to qualify as abused spouse, child, or parent under VAWA (I-360) Victim of Trafficking and his/her Spouse, Child, Sibling or Parent Certification from Office of Refugee Resettlement (ORR) ORR eligibility letter if under 18 Certification status verified through U.S. Department of Health and Human Services Trafficking Verification Line (866) Employment Authorization Document (Card) (I-766) (annotated A16, C25 ) Notice of Action (I-797)( Approval Notice for CP, T-1 or extension of T or U nonimmigrant status, T-2, T-3, T-4, T-5, ) Permanent Resident Card, Green Card (I-551) (annotated ST6, ST7, ST8, ST9, or ST0 ) Employment Authorization and Advance Parole Card (I-512)(authorization for parole, indicating T-2, T-3, T- 4, T-5, status) T-Visa Application (I-914) NOTE: Derivative Beneficiaries of Trafficking Survivors will have similar documents with T-2, 3, 4, and 5 designations COVERED CALIFORNIA TM 5
6 Nonimmigrant Statuses (letter visas aka U, S, V, etc.) Arrival/Departure Record (I-94/I-94A) (indicating admission not the U.S. with a U nonimmigrant status) Foreign Passport (indicating admission to U.S. with nonimmigrant visa) Notice of Action (I-797) ( Granting S, T, U, V nonimmigrant status, Approving application to extend/change S, T, U, V nonimmigrant status) Employment Authorization Document (Card) (I-766)(indicating nonimmigrant status) Proof of Form I-918 submission Receipt for Form I-102 or I-918 Citizen of Micronesia, Marshall Islands, and Palau Arrival/Departure Record (I-94/I-94A) Foreign Passport (annotated CFA/RMI, CFA/FSM or CFA/PAL Employment Authorization Document (Card) (I-766)(annotated A8 ) Lawful Temporary Resident Employment Authorization Document (Card) (I-766)(annotated A2, or with other evidence indicating eligibility under 210 or 245A ) Application to Adjust from Temporary to Permanent Residence under INA 245A (I-698) Applicant for Legalization under IRCA or the LIFE Act with employment authorization Employment Authorization Document (Card)(I-766)(annotated Application for Temporary Residence under INA 245A (I-687)) Foreign Passport (with a stamp or writing by INS/DHS officer, indicating pending 245A Application ) Family Unity Notice of Action (I-797)(showing approval for Application for Family Unity (I-817) ) Employment Authorization Document (Card)(I-766)(annotated A13 ) COVERED CALIFORNIA TM 6
7 Applicant for Cancellation of Removal or Suspension of Deportation with employment authorization Receipt or Notice showing filing Form EOIR-40, EOIR-42, or Application for Suspension of Deportation or Special Rule Cancellation of Removal (I-881) Employment Authorization Document (Card) (I-766) Order of Supervision with employment authorization Notice or form showing release under Order of Supervision Employment Authorization Document (Card) (I-766) Registry Applicant with employment authorization Receipt or notice showing filing Form I-485 Application to Register Permanent Residence or Adjust Status Employment Authorization Document (Card)(I-766) Member of a federally- recognized Indian tribe or American Indian born in Canada Certificate from Department of Interior certifying Native American tribal ancestry or other authoritative document COVERED CALIFORNIA TM 7
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