Job Aid: Images of Documents Typically Used by Lawfully Present Immigrants
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1 Job Aid: Images of Documents Typically Used by Lawfully Present Immigrants This PDF packet includes images of documents typically used by lawfully present immigrants when applying for Medicaid, Child Health Plan Plus, and private health insurance through the marketplace. Images of the following documents, which can be used to verify lawful presence in the U.S., are included in this packet: Certificate of Naturalization (N-550 or N-570) Certificate of Citizenship (N-560 or N-561) Permanent Resident Card ( Green Card, I-551) Employment Authorization Card (I-766) Refugee Travel Document (I-571) Arrival/Departure Record in unexpired foreign passport (I-94) Arrival/Departure Record (I-94, I-94A) issued by U.S. Citizenship and Immigration Services or U.S. Customs and Border Protection Certificate of Eligibility for Exchange Visitor Status (J-1) Certificate of Eligibility for Nonimmigrant Student Status (F-1) Reentry Permit (I-327) Machine Readable Immigrant Visa (with temporary I-551 language) Temporary I-551 Stamp (on passport or I-94, I-94A) Unexpired foreign passport Notice of Action (I-797) Note: Information included in this job aid should not be used for legal advice or guidance. This is not an exhaustive list of all immigration documents that may be used by applicants to verify immigration status and information is subject to change. For more information on immigrant eligibility and outreach and enrollment into health insurance affordability programs, visit the immigration section of the Colorado Covering Kids and Families Outreach and Enrollment Toolkit: References: Healthcare.gov (2013). Immigration Document Types. Accessed on Jan National Immigration Law Center (2014). Documents Typically Used by Lawfully Present Immigrants. Accessed on Jan. 12, 2015, Kristen Pieper CKF Project Manager (303) kristen@cchn.org Stephanie Brooks CKF Policy Analyst (303) sbrooks@cchn.org Sitora Rashidova CHC Outreach & Enrollment Coordinator (303) sitora@cchn.org 600 Grant St., Ste. 800 Denver, CO Liz Tansey CKF Outreach & Enrollment Coordinator (303) ltansey@cchn.org
2 Certificate of Naturalization NATURALIZATION CERTIFICATE NUMBER ALIEN REGISTRATION NUMBER 3
3 Certificate of Citizenship CERTIFICATE OF CITIZENSHIP NUMBER ALIEN REGISTRATION NUMBER 4
4 ALIEN REGISTRATION NUMBER CARD NUMBER (MAY BE LOCATED ON THE BACK) 9 Permanent Resident Green Card I-551 CARD NUMBER (MAY BE LOCATED ON THE FRONT) 10
5 ALIEN REGISTRATION NUMBER CARD NUMBER CATEGORY CODE Employment Authorization Card I-766.pdf EXPIRATION DATE 8
6 Refuge Travel Document I-571 ALIEN REGISTRATION NUMBER 14
7 I-94 NUMBER PASSPORT NUMBER COUNTRY OF ISSUANCE EXPIRATION DATE 6
8 I-94 NUMBER Arrival Departure Record I-94 I-94A 5
9 Certificate of Eligibility for Exchange Visitor Status DS2019 SEVIS ID 2
10 SEVIS ID Certificate of Eligibility for Nonimmigrant Student Status I-20 7
11 ALIEN REGISTRATION NUMBER Reentry Permit I
12 Machine Readable Immigrant Visa PASSPORT NUMBER ALIEN REGISTRATION NUMBER COUNTRY OF ISSUANCE 11
13 Temporary I-551 Stamp ALIEN REGISTRATION NUMBER 15
14 COUNTRY OF ISSUANCE PASSPORT NUMBER LAST NAME FIRSTNAME DATE OF BIRTH EXPIRATION DATE 9
15 Notice of Action I-797A I-94 NUMBER 12
16 Other Types of Immigration Documents: Document indicating a member of a federally recognized Indian tribe or American Indian born in Canada: There are a several documents that can show that someone is a member of a federally recognized Indian tribe or that they are an American Indian born in Canada, including membership cards, letters, or other tribal documents. For American Indians born in Canada, this could also include a birth certificate or other evidence of being born in Canada. Certification from U.S. Department of Health and Human Services (HHS) Office of Refugee Resettlement (ORR): This is a certification letter from the U.S. Office of Refugee Resettlement that s issued to an individual who is a victim of a severe form of trafficking. These letters state victims are eligible for benefits and services. Office of Refugee Resettlement (ORR) eligibility letter (if under 18): This is a letter from the U.S. Office of Refugee Resettlement and indicates a child is a victim of a severe form of trafficking. These letters state victims are eligible for benefits and services. Cuban/Haitian entrant: People who are Cuban or Haitian entrants must be Cuban or Haitian and may include one of these, for example: o o o o Granted parole into the U.S. Have an application for asylum pending with USCIS. Granted special status under the immigration laws for nationals of Cuba or Haiti. Are a subject of removal proceedings. Document indicating withholding of removal (or withholding of deportation ): There are several documents that might show withholding of removal or deportation. Resident of American Samoa: A document showing that someone is a resident of, or lives in, American Samoa. Administrative order staying removal issued by the Department of Homeland Security: A document from the Department of Homeland Security (DHS) showing an order staying removal or deportation. There are several documents that might show an administrative order staying removal issued by DHS. 16
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