(1 from each category)
_____ eWIC card (if applicable)
_____ Identification for self & for each Child:
- Originals - no copies
- Driver’s License (CURRENT)
- Birth Certificate
- Verification of Facts (only for infants)
- Social Security Card
- Current Work ID
- Shot Record (only for infants & children)
- Medicaid card (CURRENT)
_____ Proof of Where You Live: ****Does not have to be in your name and No Post Office Box
- Recent (less than 60 days old) Water, Electric, Cable, Gas or Telephone Bill
- Current Rental or Mortgage Agreement
- Medicaid Card with street address (current eligibility and correct address)
_____ Proof of Income:
- Medicaid Card (current eligibility)
- Letter of Food Stamp Eligibility
- Current paycheck stubs for everyone in household (one month’s worth)
- Written proof of all money that comes into house (SS, SSI, disability, child support, unemployment, etc)
_____ Form Completed by Your Doctor (if applicable)
_____ Formula Prescription (if applicable)