GENERAL PROVISIONS

The Department of Human Services (DHS), through federal/state programs established by the Social Security Act of 1935, as amended, the Vocational Rehabilitation Act of 1973, as amended, and through state programs established by Title 40, Chapter 5.1 and Chapter 6 of the Rhode Island General Laws, as amended, is the department in the Rhode Island state government authorized by law and designation to administer on a statewide basis the following financial, medical, social, and rehabilitation programs:

FIP Family Independence Program MA Medical Assistance (including RIte Care and RIte

Share) SSI Supplemental Security Income CCAP Child Care Assistance Program SS Social Services GPA General Public Assistance FS Food Stamp Program ORS Office of Rehabilitation Services (includes Vocational

Rehabilitation and Services to the Blind and Visually

Impaired) VA Veterans Affairs OCSS Office of Child Support Services

0100.05.05 Family Independence Program

REV:01/2002

The purpose of the Family Independence Program (FIP) is to assist working families with children who have insufficient income to meet their needs for food, shelter, clothing, child care, and medical care. The purpose of FIP is also to provide families with parents who are unemployed with financial assistance while they obtain the skills necessary for employment and provide the child care and medical care they require to be employed and ultimately become financially self-sufficient.

0100.05.10 Medical Assistance

REV:01/2002

Medical Assistance is a federal/state program authorized under Title XIX of the Social Security Act to meet the medical needs of persons receiving financial assistance under the federal/state programs and also to meet medical needs of individuals and families who have the same characteristics as persons receiving financial assistance but whose income and/or resources are greater than the limits established for the federal/state financial assistance programs but within the limits established for the medical assistance program.

0100.05.15 Supplemental Security Income

REV:01/2002

Supplemental Security Income is a federal program authorized under Title XVI of the Social Security Act to provide payments to aged, blind, and disabled persons, based on uniform national minimum standards of assistance. Rhode Island, through the Department of Human Services, provides a state supplement to the federal SSI payment and has entered into an agreement with the Social Security Administration to have the supplement administered by SSA. Eligibility for the federal minimum payment and the additional state supplement is determined by SSA; the eligibility determination for medical care under the Rhode Island Medical Assistance Program for SSI applicants is concurrent with that determination.

0100.05.20 Social Services

REV:01/2002

Social Services is a federal/state program authorized under Title XX of the Social Security Act to meet the social service needs of individuals and families who are receiving FIP or SSI and other individuals and families whose income is less than the established standard. Information and Referral Services and Protective Services are provided to any person needing the service without regard to any income criteria.

In addition to the services provided by the Department, specific services are purchased from other departments or private agencies.

0100.05.25 General Public Assistance

REV:01/2002

General Public Assistance is a state program established under Title 40, Chapter 6 of the Rhode Island General Laws, as amended, to assist a person who does not qualify for a federal/state program, but who is in need of financial and medical assistance according to the eligibility standards of DHS.

0100.05.30 RIte Works, Employment and Retention Svcs.

REV:01/2002

One of the major purposes of the FIP Program is, for families with children who have insufficient income, to facilitate the entry or re-entry of the adult members of the family into the workplace with necessary supports. FIP caseworkers and the RIte Works, Employment and Retention Unit are responsible for assisting families to access the services they need to become independent.

0100.05.35 Child Support Services

REV:10/2006

0100.05.35 Child Support Services REV: 08/2006

The Office of Child Support Services (OCSS) is a federal/state program authorized under Title IV-D of the Social Security Act and is administered by the Department of Department of Human Services - Office of Child Support Services. OCSS provides Child Support services to clients of DHS and other applicants whose children's parent(s) is absent and not supporting. OCSS is authorized to initiate action to establish paternity and/or to collect support for said children.

0100.05.40 Food Stamp Program

REV:01/2002

Food Stamps is a federal/state program authorized under the Food Stamp Act, as amended. It is designed to raise the nutritional level among low-income households whose limited food purchasing power contributes to hunger and malnutrition among members of such households. The program is administered through the Services to Individuals and Families division of DHS.

0100.05.45 Office of Rehabilitation Services

REV:01/2002

The Office of Rehabilitation Services administers a federal/state program authorized under the Vocational Rehabilitation Act of 1973, as amended, to provide rehabilitation services to individuals with physical and/or mental disabilities to assist them to enter, engage in or retain gainful employment consistent with their abilities and capabilities.

0100.05.50 Services for the Blind and Visually Impaired

REV:01/2002

Services to the Blind and Visually Impaired is a federal/state program authorized under the Vocational Rehabilitation Act of 1973, as amended, to provide a comprehensive program of Social Services, Vocational Rehabilitation, Business Enterprises, and Rehabilitation Services designed to enable blind and severely visually impaired citizens of all ages to attain their maximum potential through counseling, casework, job placement, education and training.

0100.05.55 Veteran's Affairs

REV:01/2002

Veteran's Affairs is a state program within the Department of Human Services authorized to provide the following services to veterans and their dependents: counseling or social services, information and advice regarding federal or state veterans programs and benefits, and assistance in applying for those for which there may be eligibility. Veterans' Affairs is also responsible for the administration of:

* the Veterans' Home, including a social services program, and

medical rehabilitation program;

* the Rhode Island Veterans Cemetery;

* a grave registration program; and

* the Historical Cemeteries Program.

0100.10 PURPOSE OF THE MANUAL

REV:10/2006

0100.10 PURPOSE OF THE MANUAL REV: 08/2006

The purpose of this manual is to set forth the eligibility requirements, regulations, and procedures governing the determination of eligibility, and authorization of payments/services for the FIP, Medical Assistance, Social Services, GPA, Child Support, and WIN Programs.

Separate manuals are maintained for the Food Stamp Program, Vocational Rehabilitation, Services for the Blind and Visually Impaired, and Veterans Affairs.

0100.15 MOTOR VOTER REGISTRATION

REV:10/2006

0100.15 MOTOR VOTER REGISTRATION REV: 08/2006

The purpose of the National Voter Registration Act of 1993, also called the Motor Voter Act, is to ensure that more opportunities are available for all people to register to vote or update voter registration. The Act requires that applications to register to vote be provided at agencies that provide benefits under the Family Independence Program (FIP), Medical Assistance, and Food Stamp programs as well as agencies providing services to persons with disabilities. These agencies must distribute voter registration forms, provide assistance in completing forms, and ensure that the completed forms reach the proper state election office for processing. These services are to be provided by every office where such programs are administered.

Individuals to be registered are applicants/recipients meeting all of the following criteria at application for benefits, at recertification, or if reporting a change of address. The individual must:

* Be 18 years old or over; AND

* Be present in the office at the time of the interview

or when a change of address is reported; AND

* Not be registered to vote or not registered to vote at

her/his current address.

Workers must provide the same level of assistance to individuals applying to register to vote as are provided for other applications for assistance. This includes, but is not limited to, assistance in completing the application to register to vote, unless the applicant/recipient refuses such assistance.

Workers are prohibited from trying to influence an applicant/recipient's political preference or party registration; displaying political preference/party allegiance; and making any statement or take any action that may leave the impression that a decision to register or not to register to vote will have any bearing on the availability of program services or benefits. The penalties for failure to comply with these prohibitions could result in a fine, imprisonment (not to exceed 5 years), or both.

Completion of the Voter Registration form is only an application to register to vote. The State Board of Elections makes the determination of approval or denial of the application and sends its own confirmation or denial notice to the applicant.

0102 CONFIDENTIALITY OF INFORMATION

0102.05 CRITERIA FOR USE OF CONFIDENTIAL INFORMATION

REV:10/2006

0102.05 CRITERIA FOR USE OF CONFIDENTIAL INFORMATION REV: 08/2006

The use and disclosure of information concerning applicants and recipients will be limited to purposes directly connected with the following:

* The administration of the program. Such purpose includes

establishing eligibility, determining the amount of

assistance, and providing services for applicants and

recipients.

* Any investigation, prosecution, or criminal or civil

proceeding conducted in connection with the administration

of the programs.

* The administration of any other federal or state assisted

program which provides assistance, in cash or in kind, or

services, directly to individuals on the basis of need.

For DHS, this provision is limited to those divisions and,

by agreement with the Department of Children, Youth and

Families, (DCYF) for those clients which each department

mutually serves. Any other release is with the client's

written permission, provided by the other Agency. The

disclosure to any committee or legislative body (Federal,

State or Local) of any information that identifies, by name

and address, any applicant or recipient is prohibited.

* Certification of receipt of FIP to an employer for purposes

of claiming tax credit under the Tax Reduction Act is

considered to be for a purpose connected with the

administration of the plan.

0102.05.05 State Law Governing Assistance Records

REV:01/1981

In accordance with the General Laws of Rhode Island 40-6-l2 "Records as to assistance - all records pertaining to the administration of public assistance are hereby declared to constitute confidential matter. It shall be unlawful for any person to make use of, or cause to be used, any information contained in said records for purposes not directly connected with the administration thereof or the prosecution of the war, except with the consent of the individual concerned. The director of the DHS shall have the power to establish rules and regulations governing the custody, use and preservation of the records, papers, files and communications dealing with the administration of public assistance. Said rules and regulations shall have the same force and effect as law. Said records shall be produced in response to a duces tecum properly issued by any federal or state court; provided, however, that the purpose for which the subpoena is sought is directly connected with the administration of public assistance. No subpoena shall be issued by a court asking either for said records, or for persons having custody or access to said records, unless the litigation involved in such matters is directly connected with the administration of public assistance. Any person who by law is entitled to a list of individuals receiving any of the assistance aforesaid, shall not publish or cause to be published said list except by the express consent of the Director of Human Services, or to make use thereof for purposes not directly connected with the administration thereof. Any person violating any of the provisions of this section, or the lawful rules and regulations made hereunder, shall be deemed guilty of a misdemeanor, and shall be fined not more than two hundred dollars ($200) or shall be imprisoned for not more than six (6) months, or both. Nothing in this section shall be deemed to prohibit the Director of the Department of Human Services, or his/her agents duly authorized for that purpose, from issuing any statistical material or data, or publishing or causing the same to be published whenever he/she shall deem it to be in the public interest. The Director of Human Services may inquire into the records of any state department or agency in the course of his administration of public assistance."

0102.05.10 Internal Revenue Code Requirements

REV:11/1998

Tax returns and tax information constitute confidential material that may not be disclosed in any manner. Sections 6103, 7213, and 7431 of the Internal Revenue Code (Title 26 United States Code) regulate (1) confidentiality and disclosure of returns and return information, (2) unauthorized disclosure of information, and (3) civil damages for unauthorized disclosure of returns and return information, respectively.

Pursuant to Section 6103(b)(1) "the term 'return' means any

tax or information return, declaration of estimated tax, or

claim for refund required by, or provided for, or permitted

under the provisions of this title which is filed with the

Secretary by, on behalf of, or with respect to any person,

and any amendment or supplement thereto, including

supporting schedules, attachments, or lists which are

supplemental to, or part of, the return so filed."

Pursuant to Section 6103(b)(2) "the term 'return

information' means (A) a taxpayer's identity, the nature,

source, or amount of his income, payments, receipts,

deductions, exemptions, credits, assets, liabilities, net

worth, tax liability, tax withheld, deficiencies,

overassessments, or tax payments, whether the taxpayer's

return was, is being, or will be examined or subject to

other investigation or processing, or any other data,

received by, recorded by, prepared by, furnished to, or

collected by the Secretary with respect to a return or with

respect to the determination of the existence, or possible

existence, of liability (or the amount thereof) of any

person under this title for any tax, penalty, interest,

fine, forfeiture, or other imposition, or offense, and (B)

any part of any written determination or any background file

document relating to such written determination (as such

terms are defined in section 6110(b)) which is not open to

public inspection under section 6110, but such term does not

include data in a form which cannot be associated with, or

otherwise identify, directly or indirectly, a particular

taxpayer."

Pursuant to Section 6103(b)(3) "the term 'taxpayer return

information' means return information as defined in

paragraph (2) which is filed with, or furnished to, the

Secretary by or on behalf of the taxpayer to whom such

return information relates."

Section 7213(a) of the Internal Revenue Code prohibits disclosure of any return or return information (as defined in section 6103(b) above). Violations of this statute shall be a felony punishable by a fine in any amount not exceeding $5,000, or imprisonment of not more than five (5) years, or both, together with the costs of prosecution.

Section 7431 of the Internal Revenue Code provides that any person who knowingly, or by reason of negligence, discloses any return or return information with respect to a taxpayer, is subject to civil action for damages in a district court of the United States.

0102.10 TYPES OF INFORMATION TO BE SAFEGUARDED

REV:10/1979

The types of information to be safeguarded include the following as well as any information which, at the discretion of the Director, is deemed necessary for proper administration of the program:

* Name and address of applicant or recipient;

* Information related to the social and economic conditions or

circumstances of a particular individual;

* Agency evaluation of information about a particular

individual;

* Medical data, including diagnosis and past history of

disease or disability concerning a particular individual;

* Any other material defined in law as confidential matter;

* Internal memos of the agency.

General information, not identified with any particular individual, such as total expenditures made, numbers of recipients, and other statistical information and social data contained in general studies, reports or surveys would not fall within the class of material to be safeguarded. In the use of case material for research or training, it is necessary to effectively disguise the identity of the client, his/her family and/or his/her situation.

0102.15 DEFINITION OF MAINTAINING CONFIDENTIALITY

REV:10/1979

It is the client's right and expectation that all information requested about him/her and his/her situation will be respected and safeguarded by the agency and all its personnel including field work students and volunteers. The client is made aware of his/her right to confidentiality in the application process and in other contacts with the agency.

The applicant's right to privacy shall be protected during the interview. There shall be no conversation on the information to be safeguarded within or without state or local offices except as is necessary for purposes of administering the program. All records and card files and computer files shall be properly stored and shall only be available to the staff responsible for the administration and supervision of the programs and shall not be removed from the file except when in actual use.

0102.15.05 Procedures to Maintain Confidentiality

REV:10/1979

The concept of confidentiality is inherent in the orientation for new staff members and in the ongoing in-service training of staff. It is agency practice to have all newly-appointed staff, who will have access to client records, sign a statement attesting to the fact that they have read the Rhode Island General Laws which deals with the confidentiality of records (Title 40, Chapter 6, Section l2) and that they will abide by this law. Personnel from state, city, town and private businesses from whom services are purchased, or having in their possession lists or any other information relating to clients, are required to adopt regulations safeguarding the confidential nature of the information. A letter indicating acceptance and adoption of this requirement will be considered to represent compliance.

Materials sent or distributed to applicants, recipients, or providers of services will be limited to that which are directly related to the administration of the program and will not have political implication. Excluded from mailing or distribution are materials such as "holiday" greetings, general public announcements, voting information, alien registration notices.

Materials in the immediate interest of the health and welfare of applicants and recipients, as announcements of free medical examinations and consumer protection information are not prohibited. Only the names of persons directly connected with the administration of the program are contained in material sent or distributed to applicants/recipients and vendors. Such persons are identified only in their official capacity with the department.

0102.20 DISCLOSURE OF INFORMATION

REV:10/1979

The release or use of information concerning an applicant or recipient applying for or receiving assistance or services is restricted to other social agencies whose representatives are subject to standards of confidentiality which are comparable to those of the department administering the assistance and service programs.

The individual or family is informed, whenever possible, of a request for information from a source, other than those identified in 0102.05, above, and permission is obtained to meet the request. In an emergency situation, when the individual cannot be reached to obtain consent, s/he will be notified immediately thereafter.

In the event of the issuance of a subpoena for the case record or for any agency representative to testify concerning an applicant or recipient, the request must be transmitted to the legal office through the appropriate administrator. The court will be advised by the agency's lawyer of the rules and regulations against disclosure of information. The same policy is applied to requests for information from a governmental authority, the courts, or a law enforcement official or the press or media or from any source.

0102.20.05 Disclosure of Tax Data

REV:11/1998

Section 6103(l)(7) of the Internal Revenue Code does not allow for disclosure of tax data by the states except when such disclosure is for the purposes of, and to the extent necessary in, determining eligibility for, or the correct amount of benefits under an appropriate public assistance program. The taxpayer does not have authority to authorize the Department of Human Service to disclose tax data in his/her file.

0104 CITIZENSHIP OR ALIENAGE

0104.05 ELIGIBILITY FACTORS OF CITIZENSHIP/ALIENAGE

REV:09/1988

To be eligible for any assistance program, an otherwise eligible applicant must be a member of one of the following categories:

- A United States Citizen

- A Repatriate

- An Amerasian

- A Resident Alien

- An American Indian Born in Canada

- An Alien Residing in U.S. Under Color of Law

- A Legal Temporary Resident (LTR)

0104.05.05 United States Citizen

REV:09/1988

Definition

A United States citizen is defined in the Immigration and Nationality Act as any person born in any of the 50 States, the District of Columbia, Puerto Rico, Guam, or the United States Virgin Islands. Nationals from American Samoa or Swain's Island are also regarded as United States Citizens, as are those persons who are naturalized U.S. citizens.

Verification

The following constitute documentation of United States citizenship:

* Birth Certificate;

* Religious document such as a baptismal record, recorded

within three months of birth showing that the birth took

place in the United States;

* United States passport;

* Report of Birth Abroad of a Citizen of the United States

(Form FS-240);

* Certification of Birth (Form FS-545);

* United States Citizen I.D. Card (I-97);

* Naturalization Certification (N-550); or

* Certificate of Citizenship (N-560).

Various "documents" issued by an organization called the World Council of Washington, D.C. are considered bogus and unacceptable as evidence of identity, citizenship, age, etc., for enumeration or other official purposes. These "documents" include: World Birth Certificates, World Citizen Cards, World Identity Cards, and World Marriage Certificates.

0104.05.10 Repatriate

REV:09/1988

Definition

A repatriate is a citizen or a dependent of a citizen, identified by the United States Department of State as having returned or been brought from a foreign country because of the destitution or illness of the citizen or any of his/her dependents or because of war, threat of war, invasion, or similar crisis and who is without available resources. Such a person would be referred by a Central Office contact.

Verification

Verification is made by documenting United States citizenship, as above.

0104.05.15 Amerasian

REV:09/1988

Definition

Certain Amerasians may have a claim to United States citizenship under Section 301 (g) of the Immigration and Nationality Act, as made applicable by Section 309 (a) (amended November 14, 1986), if such Amerasian was:

* A resident of Vietnam as of the date (December, 1987), of

the Amerasian Homecoming Act, Section 584 of the Continuing

Resolution for Fiscal Year 1987 (P.L. 100-200);

* Born in Vietnam after January 1, 1962 and before January 1,

1976, and;

* Fathered by an identified United States citizen.

Verification

In order to establish United States citizenship for such Amerasian, an identified American father must meet several requirements under the law, which may include:

* Establishment of both blood and legal relationship to the

child;

* Acknowledgement of paternity in writing under oath; and

* Agreement to provide financial support until the child's

eighteenth birthday.

Refugee Benefits

An Amerasian not entering the United States as an American citizen or as a beneficiary of an immediate relative or preference visa petition, filed on her/his behalf by relatives in the United States, may be eligible for refugee benefits. (See Section 901, III, A., B., C., and D.)

0104.05.20 Resident Alien

REV:10/2006

0104.05.20 Resident Alien REV: 08/2006

Definition

A resident alien is one who was lawfully admitted for permanent residence in accordance with the immigration laws, such status not having changed since admission.

A resident alien, sponsored by an individual or organization and applying for FIP within three years following entry into the United States, shall, as a condition of eligibility:

* Provide information and documentation from the sponsor in

support of his/her immigration application.

* Obtain the cooperation of the sponsor for the purpose of

determining the income and resources that can be deemed

available to the resident alien.

Refer to Section 0214 for determination of alien sponsorship liability.

The eligibility requirements for GPA, for such resident alien, are defined in Section 0608. Refer to the DHS Manual Section 0612 for treatment of income from an alien sponsor in the GPA Program.

Verification

The following INS forms may be used as evidence to determine whether an alien is lawfully admitted for permanent residence:

* Form I-181, Memorandum of Creation of Record of Lawful

Permanent Residence, is a temporary identification document

issued by an INS field office pending issuance of an Alien

Registration Receipt Card;

* Forms AR-3 and AR-3a, Alien Registration Receipt Card.

This document was issued between 1941 and 1949 and pertains

to a lawful permanent resident alien;

* Form I-151, Alien Registration Receipt Card. This document

was issued prior to June 1978 and remains valid

indefinitely.

* Form I-551, Resident Alien Card. This is the current

document given to a lawful permanent resident alien and is

valid indefinitely. This form is commonly referred to as a

"green card";

Lawful temporary resident aliens who become lawful

permanent residents will be issued Form I-551 with a

registration number in the 90-million series. In addition,

the date such aliens are granted LTR status is indicated as

the fourth line on the reverse of the form. The fourth

line will read:

"TEMP RES ADJ DATE - MM/DD/YY." Eligibility for FIP, full

Medical Assistance and Food Stamp benefits will exist five

(5) years from the date that appears on the reverse of the

I-551.

* Form I-551, Resident Alien Card (Conditional Resident

Alien). This form is issued to a conditional permanent

resident, such as an alien spouse of a U.S. citizen. It is

the same form as issued to a permanent resident alien but

is valid for a limited period of time and has an expiration

date stamped on the back; or

* Form I-327, Re-entry Permit, is issued to a lawful

permanent resident alien before s/he leaves the U.S. for a

one-to-two-year period. This document contains an

expiration date.

0104.05.25 American Indian Born in Canada

REV:09/1988

Definition

An American Indian born in Canada who has maintained residence in the United States since entry is considered lawfully admitted for permanent residence if s/he is at least one-half American Indian blood. This does not include the non-citizen spouse or child of such Indian or a non-citizen whose membership in an Indian tribe or family is created by adoption unless such person is at least 50% or more American Indian blood.

Verification

Types of documentation include:

* Birth or baptismal certificate issued on a reservation;

* Tribal records;

* Letter from the Canadian Department of Indian Affairs; or,

* School records.

0104.05.30 Alien Residing in U.S. Under Color of Law

REV:09/1988

Definitions:

An alien who entered the United States prior to January 1,

1972 is considered "permanently residing under color of law"

and may be eligible for lawful permanent resident (LPR)

status in accordance with Section 249 of the Immigration and

Nationality Act.

* A conditional entrant lawfully present in the United States

under the provisions of Section 203 (a)(7) (prior to

4/1/80);

* A refugee under Section 207(c) (after 3/31/81) (Refer to the

Refugee Assistance Program, Section 900, for specific

eligibility and verification procedures.);

* An asylee under Section 208 or a parolee under Section 212

(d)(5). Asylum or parole into the United States may be

provided at the discretion of the U.S. Attorney General,

for an indefinite temporary period for emergency reasons or

for reasons in the public interest.

* An alien granted "voluntary departure." A Cuban refugee or

any other alien who was not legally paroled into the United

States may be granted "voluntary departure" for an

indefinite period or may be granted an indefinite stay of

deportation because of: humanitarian considerations or

technical difficulties which cannot be overcome and which

prevent the Immigration and Naturalization Service (INS)

from deporting them.

* A Western Hemisphere alien. An alien from a Western

Hemisphere country who applied for a residency visa between

July l, l968 and December 3l, l976, but entered the United

States before their visa was granted and whose last entry

was before March ll, l977, is allowed to remain in the

United States until further notice without threat of

expulsion or deportation under a temporary restraining order

granted in the United States District Court, Northern

District, Illinois (Silva v. Levi).

Verification

For an alien in the United States prior to l972, a record showing the alien to have been in the United States prior to l972, such as school, marriage, medical, insurance applications, or driver's license, are used as verification of residence. In lieu of such documents, a statement from two persons attesting to the fact that the claimant was in the United States prior to l972 and the basis of their knowledge may be used.

A Western Hemisphere Alien should have the following court ordered notice: "Due to a Court Order in Silva v. Levi, 76- C4268, entered by District Judge John F. Grady in the District Court for the Northern District of Illinois, we are taking no action on your case. This means that you are permitted to remain in the United States without threat of deportation or expulsion until further notice. Your employment in the United States is authorized."

All persons admitted "under the color of the law" should have one of the following documents:

* Form I-l5l, Alien Registration Receipt card--with photograph

(for permanent resident aliens). This card was in use prior

to 1979;

* Form I-55l, Resident Alien card--for permanent resident

aliens;

* Form AR-3a, Alien Registration Receipt Card--issued during

1941-1949 for permanent resident aliens;

* Form I-94, Arrival-Departure Record--annotated either

"Section 207" or "Refugee," or "Section 208" or "Asylum";

* Form I-94, Arrival-Departure Record-Parole Edition--

annotated either "Section 212 (d)(5)", or "Conditional

Entry" or "Section 203 (a)(7)";

* Form I-94, Arrival-Departure Record--annotated "Section

243(h)";

* Form I-94, Arrival-Departure Record--annotated "Cuban-

Haitian Entrant".

0104.05.35 Legal Temporary Resident

REV:09/1988

Definition

An alien admitted for legal temporary residence (LTRs) under Section 245 A(a)(1) of the Immigration Reform and Control Act of 1986.

Verification

An individual in this status must have one of the following documents:

* INS Form I-689, Fee Receipt. This document is issued to an

applicant for status under the legalization (amnesty) or SAW

programs. Expires on the date of the legalization

interview.

* INS Form I-688A, Employment Authorization card is issued to

an applicant for temporary resident alien status after the

initial interview for legalization (amnesty) or SAW status.

It expires six months from the date of the issuance. The

expiration date is on the card.

* INS Form I-688, Temporary Resident card. This form is

issued to an alien granted LTR status under the legalization

or SAW programs. It remains valid until the expiration date

stamped on the card.

0104.05.40 General Verification of Documentation

REV:09/1988

All immigration documentation presented that does not contain a photograph should be accompanied by another identity document bearing a photograph of the applicant whenever possible.

0104.10 INELIGIBLE ALIENS

REV:10/2006

0104.10 INELIGIBLE ALIENS REV: 08/2006

Aliens who do not fall under one of the foregoing categories but who are lawfully admitted for a temporary or specific length of time are not eligible for FIP, GPA, SSI, or Food Stamps.

However, such aliens may be eligible for emergency medical services under the Medical Assistance (MA) program providing they meet all other eligibility requirements for the MA program.

See 0104.25.

The following categories of individuals are ineligible aliens:

* Foreign government representatives on official business and

their families and employees.

* Visitors for business or pleasure, including exchange

visitors.

* Aliens in travel status while traveling directly through

the United States.

* Crewmen on shore leave.

* Treaty traders and investors and their families.

* Foreign students.

* International organization personnel and their families and

servants.

* Temporary workers, including agricultural contract workers.

* Members of foreign press, radio, film or other information

media and their families.

These aliens should have one of the following types of documents:

_ I-94, Arrival-Departure Record;

_ I-l85, Canadian Border Crossing Card;

_ I-l86, Mexican Border Crossing Card;

_ SW-434, Mexican Border Visitor's Permit;

_ I-95A, Crewman's Landing Permit; or

_ I-l84, Crewman's Landing Permit and Identification Card.

0104.15 ILLEGAL ALIENS

REV:06/1988

Illegal aliens are those individuals who have entered the country unlawfully. In general, such aliens are not eligible for assistance programs. Exceptions are limited to specific services provide by:

* Medical Assistance; see Section 0104.25

* Social Services; see Section 500.2, I.,B., and C.

0104.20 ALIEN LEGALIZATION PROGRAM UNDER IRCA

REV:02/1989

In order to participate in the legalization program under the Immigration Reform and Control Act of 1986 (IRCA), an alien must have entered the United States before January 1, 1982 either unlawfully or on a nonimmigrant visa which expired before January 1, 1982, and must have lived in the United States in an unlawful status continuously since January 1, 1982. An alien living in the United States in an unlawful status who wishes to be legalized must apply for legalization during the 12-month period beginning May 5, 1987. (For special exemptions from the entry date and date of application for certain alien groups, see 0104.20.05.) The alien must establish to the satisfaction of the Immigration and Naturalization Service (INS) that s/he meets the conditions for legalization set forth in the law. Those conditions are:

* Continuous unlawful residence in the United States since

January 1, 1982.

* Continuous physical presence in the United States since

enactment of IRCA.

* The alien is admissible as an immigrant.

The preceding rules apply to every alien eligible for legalization including the children, spouse or parents of legalized aliens. If an individual granted legalization does not apply for legalization for his/her minor non-citizen children, those children are not legalized under the program.

In general, the Immigration and Naturalization Service (INS) is exercising the U.S. Attorney General's discretion by granting indefinite voluntary departure status to unmarried children under the age of eighteen (18) years who can establish that they were in an unlawful status prior to November 6, 1986. Such children should be residing with their parent(s) who have achieved lawful temporary resident status.

0104.20.05 Aliens Eligible to Apply for Legalization

REV:02/1989

Specific categories of aliens who are eligible to apply for legalization include:

Special Agricultural Workers (SAWs)

These aliens must apply for legalization during the 18-month period beginning June 1, 1987. SAWs are divided into two groups based on the length of time the alien has worked in agriculture prior to May 1, 1987, and subject to numerical limitation.

Once an application for legalization is approved by the INS, the SAW is granted lawful temporary resident (LTR) status.

Subsequently, SAWs will be adjusted from LTR to lawful permanent resident (LPR) status without any action by the alien. The adjustment to LPR will occur on December 1, 1989 for SAWs granted LTR prior to November 30, 1988. For SAWs granted LTR status after November 30, 1988, adjustment will occur 12 months after being granted LTR status.

Replenishment Agriculture Workers (RAWs)

Beginning in October, 1989, IRCA provides for the admission of additional aliens to meet a shortage of agricultural workers.

RAWs granted Legal Temporary Resident (LTR) status prior to November 30, 1988 will be adjusted to Legal Permanent Resident (LPR) status December 1, 1990. Those granted LTR status after November 30, 1988 will be adjusted to LPR status 24 months after being granted LTR status.

Aliens from Poland, Afghanistan, Ethiopia and Uganda

The Continuing Resolution for fiscal year 1988 (Public Law 100- 202) allows aliens from Poland, Afghanistan, Ethiopia and Uganda who have been in the U.S. since before July 21, 1984 to apply for Lawful Temporary Resident (LTR) status. The application period for this group began March 21, 1988 and will continue through December 22, 1989.

Aliens Other than SAWs/RAWs

Such aliens must complete the requirements for Legal Temporary Resident (LTR) status outlined in 0104.05.35. To adjust their status from Legal Temporary Resident (LTR) to Legal Permanent Resident (LPR), such aliens must apply for Legal Permanent Resident (LPR) status during the 12-month period beginning with the 19th month of Legal Temporary Resident (LTR) status, and must establish to the satisfaction of the INS that such aliens:

* Have resided continuously in the United States since being

granted LTR status;

* Are admissible as immigrants;

* And have, as defined by the INS, basic citizenship skills.

0104.20.10 Termination of Legal Resident Status

REV:06/1988

Termination of Legal Resident Status (LTR or LPR) will occur if:

* An alien fails to apply for adjustment to LPR status during

the 12 months when permitted to do so.

* The Attorney General determines that the alien was not

eligible for LTR status.

* The alien commits an act which makes the alien inadmissible

as an immigrant.

* An application for LPR status is denied.

* The Attorney General determines that a SAW is deportable.

0104.25 ACCESSIBILITY TO ASSISTANCE PROGRAMS

REV:10/2006

0104.25 ACCESSIBILITY TO ASSISTANCE PROGRAMS REV: 08/2006

To be determined eligible, an individual, regardless of citizenship or immigration status, must satisfy all relevant eligibility criteria for each program for which an application is submitted. Accessibility to certain assistance programs is limited by an individual's immigration status as follows:

FIP

Applications for FIP may be submitted by citizens and individuals permanently residing in the United States under color of law.

The following three categories are barred from FIP participation for five years, beginning on the date they are issued lawful temporary residence (LTR) status, in accordance with IRCA (P.L.

99-603):

* Aliens lawfully admitted for temporary residence (LTRs)

under Section 245A.

* Special Agricultural Workers (SAWs) under Section 201.

* Replenishment Agricultural Workers (RAWs) under Section

210A.

Medical Assistance

Accessibility for Medical Assistance is restricted to citizens, lawful permanent residents and individuals permanently residing in the United States under color of law. In addition, certain illegal aliens, ineligible aliens and aliens legalized by IRCA, may access specific services provided by the Medical Assistance Program.

* Full Benefits are available to:

Citizens, lawful permanent residents and individuals

permanently residing in the United States under color

of law, provided they meet the categorical and

financial criteria for the program; and

Aliens who are adjusted to lawful temporary resident

status (LTR) after May 5, 1987, including but not

limited to, LTRs who are Cuban/Haitian entrants, SAWs

and RAWs, if the following conditions are met:

- applicants must meet the categorical and

financial criteria for Medical Assistance, and

- must be either, aged, blind, disabled, child(ren)

under 18 years of age or a pregnant woman.

* Emergency Services

Effective January 1, 1987, Medical Assistance coverage for

Emergency Services is accessible to all persons regardless

of citizenship status, provided such persons are residents

of Rhode Island and meet the categorical and financial

criteria for the Medical Assistance Program. In addition,

each applicant must have a medical condition (including

emergency labor and delivery) manifesting itself by acute

symptoms of sufficient severity (including severe pain)

such that in-patient hospital or hospital emergency room

treatment is required.

* Services for Pregnant Women

Pregnant ineligible aliens (as described in 0104.10) and

pregnant illegal aliens who meet the Medical Assistance

criteria for Emergency Services, are only eligible for

emergency labor and delivery services.

Food Stamp Program

Otherwise eligible citizens and individuals granted permanent resident status are eligible to participate in the Food Stamp Program. In addition, the following aliens admitted for temporary residence pursuant to IRCA of 1986 may participate in the program, if they meet the categorical and financial criteria of the program.

_ Special Agricultural Workers (SAWs) as of the date of

lawful admittance (June 1, 1987 or thereafter);

_ Replenishment Agricultural Workers (RAWs) as of the date of

lawful admittance, beginning October 1, 1989 through

September 30, 1993; and,

_ Aliens who are granted lawful temporary resident status

under IRCA regulations are eligible to participate after a

five-year period from the date temporary resident status is

granted which is no earlier than November 7, 1988.

Supplemental Security Income

Supplemental Security Income (SSI) may be accessed by citizens, lawful permanent residents, individuals permanently residing in the United States under color of law and aliens legalized by IRCA, if they meet the specific categorical and financial criteria for the program.

0104.25.05 Programs Accessible to Legalized Aliens

REV:06/1988

The following is a list of programs which legalized aliens may access, provided they otherwise qualify:

_ The National School Lunch Act;

_ The Child Nutrition Act of 1966;

_ The Vocational Education Act of 1963;

_ Chapter 1 of the Education Consolidation and Improvement Act

of 1981;

_ The Headstart-Follow Through Act;

_ The Job Training Partnership Act;

_ Title IV of the Higher Education Act of 1965;

_ The Public Services Act; and

_ The following programs derived from the Social Security Act:

Parts B, D, and E of Title IV as they relate to child

support, child welfare services, and foster care and

adoption assistance; Title V - The Housing Act of 1949;

Title XVI - Supplementary Security Income; and, Title XX -

The Maternal and Child Health and Social Services Block

Grant.

0104.30 VERIFICATION OF DOCUMENTATION

REV:06/1988

The Immigration Reform and Control Act of 1986 (IRCA) mandates:

* The exchange of immigration status information among state

and federal assistance programs; and

* The use of that data in determining eligibility for

benefits; and,

* The establishment of the Systematic Alien Verification for

Entitlements (SAVE) program to accomplish the above goals

beginning in FY 1989.

0104.30.05 Disclosure of Information

REV:02/1989

The law provides that the use of information concerning an applicant/recipient can be used only for the administration of the Department's programs. If it is determined that an appli- cant/recipient is an illegal alien, this information is not to be disclosed to the INS. For SAVE participation and procedural requirements, see 0104.40 through 0104.75

0104.40 DEFINITION OF THE SAVE PROGRAM

REV:02/1989

The Systematic Alien Verification for Entitlements Program is the Immigration and Naturalization Service operated system for the verification of immigration status of aliens applying for benefits from certain federally-funded entitlement programs.

0104.40.05 Legal Basis for the SAVE Program

REV:02/1989

Section 121 of the Immigration Reform and Control Act of 1986 (IRCA) mandates:

* The verification of immigration status of aliens applying

for benefits under certain programs; and

* The exchange of income-related information among state and

federal assistance programs and the use of that data in

determining eligibility for benefits and payment amounts.

* The establishment of the Systematic Alien Verification for

Entitlements (SAVE) program to accomplish the above goals

beginning in FY 1989.

0104.45 SAVE PROGRAM REQUIREMENTS

REV:02/1989

Beginning on December 1, 1988, applicants for most major assistance programs must declare in writing that they are United States citizens or nationals, or that they are in "satisfactory immigration status." Use the DHS/SAV-1 for the declaration of citizenship or alienage.

Verification of U.S. citizenship or naturalized citizen status is accomplished by the applicant providing a valid birth certificate, U.S. passport or other acceptable documentation.

(See Sections 104.05.05 - 104.05.15.)

To be considered in "satisfactory immigration status," an applicant must provide either:

* Alien registration documentation of proof of immigration

registration from the INS containing the alien's admission

or file number, or

* Such other documents as constitute reasonable evidence of

satisfactory immigration status. (See Sections 104.05.20 -

104.05.35.)

0104.45.05 Presumptive Eligibility/Immigration Status

REV:02/1989

An otherwise eligible documented alien applicant is eligible for benefits unless proven otherwise. No eligible documented alien is denied benefits based solely on an automated computer check.

Eligibility is revoked only following a secondary verification procedure.

0104.45.10 Not In Satisfactory Immigration Status

REV:02/1989

When an applicant or a recipient is an illegal alien or an alien not in "satisfactory immigration status," information regarding such applicant/recipient is used only for the administration of the Department's programs.

* Illegal aliens and others not in "satisfactory immigration

status" may be eligible for certain restricted Medical

Assistance benefits. (See Section 102.25.)

* Such aliens are not required to sign the DHS/SAV-1,

Certification of Citizenship/Alienage.

0104.50 THE PURPOSE OF THE SAVE PROGRAM

REV:02/1989

The Immigration Reform and Control Act of 1986 (IRCA) reflects the resolve of the Congress and the INS to control illegal immigration by using employer sanctions and alien verification for certain assistance programs (as shown in 0104.50.05), to reduce incentives for aliens to come and remain in the United States illegally, and in addition, to provide a significant cost avoidance potential for federally funded programs.

0104.50.05 Benefit Program Participation

REV:10/2006

0104.50.05 Benefit Program Participation REV:08/2006

IRCA mandates that the following programs and overseeing agencies participate in the verification process:

* The Food Stamp Program (U.S. Department of Agriculture);

* Certain Housing Assistance Programs (U.S. Department of

Housing and Urban Development);

* Unemployment Compensation (U.S. Department of Labor);

* Title IV Education Assistance (U.S. Department of

Education);

* Family Independence Program,

* Medical Assistance, and

* Certain Territorial Assistance Programs, such as,

Supplemental Security Income (U.S. Department of Health and

Human Services).

0104.55 LEGAL REQUIREMENTS FOR DOCUMENTATION

REV:02/1989

* U.S.C. 1304, title B, Section 264, states that aliens in the

U.S. must always have immigration documentation in their

possession.

* All alien applicants for entitlement benefits must present

original documentation of alien registration or another form

of documentation that the agency determines is reasonable

evidence of the alien's immigration status.

* Most alien applicants will present documentation that

contains an Alien Registration Number. This number is

commonly referred to as the A-Number. It references the

individual's Alien File at INS.

* The A-Number contains seven or eight numerical digits

preceded by the letter "A," such as, A24 786 899. Each A-

Number is unique in that it pertains to one person only.

Even minors and infants in the U.S. as immigrants are

assigned individual A-Numbers.

* Some INS documents do not contain a photograph of the

bearer. When an alien presents such documentation, the

applicant or recipient must present an additional

identifying document that includes a photograph, such as a

driver's license or an employer badge, whenever possible.

* Any alien applicant or recipient claiming that his/her

documents were lost or stolen must be referred to the INS

office to request replacement documentation prior to primary

or secondary verification procedures.

0104.55.05 Types of Documentation

REV:10/2006

0104.55.05 Types of Documentation REV: 08/2006

Immigration documentation includes, but is not limited to, the following forms. Unless specifically indicated, each shows the Alien Registration Number (A-Number) of the bearer. Some forms, as indicated, have expiration dates. These dates must be checked during the application process to insure that the forms are still valid.

Use the following INS forms as evidence to determine whether an alien is a lawful permanent resident or is an individual permanently residing under color of the law:

* Form I-181, Memorandum of Creation of Record of Lawful

Permanent Residence, is a temporary identification document

issued by an INS field office pending issuance of an Alien

Registration Receipt Card;

* Form AR-3 and AR-3a, Alien Registration Receipt Card. This

document was issued between 1941 and 1949 and pertains to a

lawful permanent resident alien;

* Form I-151, Alien Registration Receipt Card. This document

was issued prior to June, 1978 and remains valid

indefinitely;

* Form I-551, Resident Alien Card. This is the current

document given to a lawful permanent resident alien and

remains valid indefinitely. This form is commonly referred

to as a "green card;"

Lawful temporary resident aliens who become lawful

permanent residents will be issued Form I-551 with a

registration number in the 90-million series. In addition,

the date such aliens are granted LTR status is indicated as

the fourth line on the reverse of the form. The fourth

line will read: "TEMP RES ADJ DATE - MM/DD/YY."

Eligibility for FIP, full Medical Assistance and Food Stamp

benefits will exist five (5) years from the date that

appears on the reverse of the I-551.

* Form I-551, Resident Alien Card (Conditional Resident

Alien). This form is issued to a conditional permanent

resident, such as an alien spouse of a U.S. citizen. It is

the same form as issued to a permanent resident alien but

is valid for a limited period of time and has an expiration

date stamped on the back;

* Form I-327, Re-entry Permit, issued to a lawful permanent

alien before s/he leaves the U.S. for a one-to-two- year

period. This document contains an expiration date.

* Form I-94, Arrival-Departure Record is issued by INS to

non-immigrant aliens. It should be attached to an

unexpired foreign passport. However, most refugees will

not have passports. The Form I-94 may not include an A-

Number nor contain a photograph. The document may bear one

of the following annotations: Section 207 - Refugee;

Section 208 Asylum; Section 243(h); Cuban-Haitian Entrant;

or Employment Authorized.

* Form I-94, Arrival-Departure Record-Parole Edition is

issued as above. It may contain one of the following

annotations: Section 203(a)(7) - Conditional Entry or

Section 212(d)(5) Parolee.

* Form I-571, Refugee Travel Document is issued by INS to

aliens who are granted refugee status. This document

contains an expiration date.

0104.55.10 Documentation of Legal Temporary Residence

REV:02/1989

An alien admitted for Legal Temporary Residence (LTRs) under Section 245 A(a)(1) of the Immigration Reform and Control Act of 1986 should present one of the following forms:

* INS Form I-689, Fee Receipt. This document is issued to an

applicant for status under the legalization (amnesty) or

Special Agricultural Workers (SAWs) programs. It expires on

the date of the legalization interview.

* INS Form I-688A, Employment Authorization Card This form is

issued to an applicant for temporary resident alien status

after the initial interview for legalization (amnesty) or

SAW status. It expires six months from the date of the

issuance. The expiration date is on the card.

* INS Form I-688, Temporary Resident Card. This form is

issued to an alien granted LTR status under the legalization

or SAW programs. It remains valid until the expiration date

stated on the card.

0104.60 VERIFICATION OF DOCUMENTATION

REV:09/1989

Applicants

At the time of application, the agency representative makes a photocopy of both sides of all pertinent original immigration documentation presented for each individual family member.

Recipients

Use the same procedure as above, if the recipient's documents were not verified during the application process.

The photocopies are necessary for the determination of eligibility, since:

* Accessibility to certain assistance programs is limited by

an individual's immigration status. (See Section 0104.25);

and

* IRCA mandates that each applicant verify that s/he is a U.S.

citizen, national or is in "satisfactory immigration

status."

The Systematic Alien Verification for Entitlements (SAVE) program provides two ways to verify an alien applicant's immigration documentation through either Primary Verification or Secondary Verification.

0104.60.05 Definition of Primary Verification

REV:03/1989

The Immigration and Naturalization Services maintains the Alien Status Verification Index (ASVI) data base for participants in the SAVE program. It contains information regarding over 22 million aliens and is used for the initial automated document verification. This automated process is known as primary verification.

The Department of Human Services has opted to use a standard telephone line to access the ASVI system. The Office of Refugee Resettlement has been authorized to be the central alien data information and referral office for DHS.

In general, primary verification is initiated for all applicants or recipients, except for those aliens having certain immigration status or who are in those situations specifically identified in Section 0104.65.

0104.60.10 Primary Verification Procedures

REV:09/1989

The agency representative uses the following procedures for primary verification:

Makes a photocopy of both sides of all original verifying documentation, which is kept in the individual's/family's case record;

Returns the originals to the applicant/recipient;

Enters the following information on the Primary Document Verification Request, Form DHS/SAV-2;

* The A-Number for each individual in the applicant's or

recipient's filing unit;

* The last, first, and middle name, for each individual in the

applicant's or recipient's filing unit;

* The agency representative's name, E.I.N. number, district

office and district office telephone number on the back of

the form.

* Forwards the DHS/SAV-2, attached to an AP-60 transmittal, to

the ORR Data Management Officer at the following address:

Office of Refugee Assistance

275 Westminster Mall

Providence, R.I. 02903

Upon receipt of the DHS/SAV-2 Form, the ORR Data Management Officer will:

* Access ASVI by entering the A-Number(s) into the data bank;

* Interpret the resulting Alien Status Verification Display;

* Note on the DHS/SAV-2, the unique Verification Number issued

to each alien by the ASVI system when an inquiry is

instituted;

* Return the Primary Document Verification Request, Form

DHS/SAV-2, to the correct agency supervisor after checking

the appropriate response, either "valid" or "institute

secondary verification." The supervisor then forwards the

DHS/SAV-2 to the agency representative.

* On a weekly basis, distribute a list of the names of those

aliens whose documents must be processed for secondary

verification to the Regional Managers.

The agency representative retains the completed DHS/SAV-2, containing the alien Verification Number, in the applicant's/recipient's case record for further reference. No further check is required, unless the ORR Management Officer records on the DHS/SAV-2 that the ASVI system displayed "Institute Secondary Verification."

SUMMARY OF VERIFICATION REQUIREMENTS

Initiate Immediate

Primary Secondary

Valid-appearing I-551, I-151, AR-3A,

I-688, I-327, or I-571 with an

A-Number between A0 000 001 and X

A59 999 999

Counterfeit-appearing or altered X

document

No A-Number on document X

A-Number in A60 000 000, A70 000 000,

or A80 000 000 series X

I-688, I-688A or I-689 X

I-181, or I-94 in a foreign passport

that bears the endorsement "Temporary

Evidence of Lawful Admission for

Permanent Residence," processed over

one year ago X

Any INS receipt, except the I-689 X

Other I-181, or endorsed I-94 on a

foreign passport X

0104.60.15 Definition of Secondary Verification

REV:03/1989

Secondary Verification provides a more extensive validation procedure, including a thorough search of all applicable automated and paper INS files, when problems arise during the visual verification of documentation or during the primary check.

A response during the primary verification to institute a secondary verification means that the present classification in the computer data base (ASVI) indicates something other than permanent resident alien status. In some instances, it simply means that the alien's record is very new.

Secondary verification must be completed:

* Whenever there is a discrepancy between information on ASVI

and information presented by the applicant; and

* Prior to the delay, denial, reduction, or termination of a

benefit to any alien applicant for reasons of immigration

status.

0104.60.20 Immediate Secondary Verification

REV:09/1990

In most circumstances, the agency representative will execute primary verification prior to initiating secondary verification procedures. However, the following circumstances require that secondary verification be initiated immediately:

* When any one of the items presented as documentation appears

to be counterfeit or altered;

* When an alien presents unfamiliar INS documentation, or a

document that indicates immigration status, but does not

contain an Alien Registration Number (A-Number);

* When the document contains an A-Number in the A60 000 000 or

A70 000 000 series. These ranges have not yet been issued;

* When the document contains an A-Number in the A80 000 000

series. This range is used for illegal border crossings;

* When the document presented is any form of INS receipt,

except the I-689;

* When the document presented is a Memorandum of Creation of

Record of Lawful Permanent Residence (Form I- 181) or an

Arrival-Departure Record (Form I-94) attached to a foreign

passport that bears the endorsement "Processed for I-551,

Temporary Evidence of Lawful Permanent Residence," and that

I-181 or I-94 is over one year old.

* Additionally, secondary verification should occur after an

automated check when ASVI returns a response of "Institute

Secondary Verification," or when there is a material

discrepancy between an alien's documentation and the record

contained in ASVI. The Data Management Officer will inform

the agency representative if such a discrepancy exists.

0104.60.25 Secondary Verification Procedures

REV:09/1990

When the Data Management Officer returns the DHS/SAV-2, indicating the necessity for Secondary Verification, the agency representative initiates the Secondary Verification procedures.

The worker completes a Document Verification Request (Form G-845) for each applicant or recipient. If a family unit is applying or being recertified, each member will require a separate Form G- 845. It is essential that the form contain enough information to identify the alien, including:

* Alien Registration or I-94 Number: Enter the A-Number as

the letter "A" followed by the correct seven or eight

digits, or include the Admission Number, if found on the I-

94.

* Applicant's Name: Enter the last, first, and middle name of

the applicant/recipient. If the documentation indicates

more than one variation of the name, enter all versions. In

the case of a recent marriage, the alien may not yet have

furnished the new name to INS. In such cases, record both

the maiden and married names.

* Nationality: Enter the foreign nation or country to which

the applicant/recipient owes legal allegiance. This is

normally, but not always, the country of birth.

* Date of Birth: Enter the birth date using the MM/DD/YY

format. If the complete date of birth is not known, enter

the available information.

NOTE: Some cultures record dates as day, month and year

using format DD/MM/YY, for example, 010457 is

April 1, 1957. Some aliens continue to provide dates in

this fashion. For INS purposes, be sure to transpose the

numbers and use the MM/DD/YY format.

* Social Security Number: Enter the alien's nine-digit Social

Security Number, if known. Copy the number directly from

the alien's Social Security card whenever possible.

* Verification Number: Enter the Verification Number assigned

by the ASVI query, if available.

* Photocopy of Document Attached/Other Information Attached:

Indicate that INS documentation is attached by checking the

top box. Use the bottom box if other information is

included in support or in lieu of INS documents.

* Benefit/Case Number: Mark the blocks showing the program(s)

for which the alien is applying or being recertified.

* The agency representative includes her/his name, title,

telephone number, and the current date. The name and

address of the agency must be typed or stamped in the block

labeled "From."

Upon completion of the Form(s) G-845, make one copy of the form(s) and retain in the case record.

A photocopy of all applicable printed pages of each piece of original immigration documentation must be attached to the original G-845 form(s). In addition, the attachments should include copies of:

* Identification bearing a photograph of the

applicant/recipient, whenever possible; and

* Any other pertinent documents submitted by the alien, such

as a marriage record or court order.

0104.60.30 INS G-845 Documentation Verification Request

REV:09/1989

Copies of all necessary documentation are stapled to the Form(s) G-845 with a single staple in the upper left-hand corner.

Enter in the "To" address area:

INS

U.S. Post Office and Federal Building, Room 203

Exchange Terrace

Providence, RI 02901

The form and documents should then be folded and placed in a window envelope so that the block labelled "To" appears in the address area.

More than one Form G-845 may be mailed in a single envelope.

However, the INS discourages bulk mailing of the forms.

The Documentation Verification Request, Form G-845, is a self- reply form. Upon receipt of the G-845, the INS Immigration Status Verifier will:

* Research the alien's records in the INS files;

* Complete the response portion of the form(s) by checking all

appropriate statements on the lower half and the back of the

form(s) to indicate the applicant's/recipient's immigration

status and work eligibility; and

* Return both the form(s), the attached photocopies and the

INS form entitled, U.S. department of Justice Immigration

and Naturalization Service, to the agency representative

within fifteen working days of receipt.

The agency representative should take special action when one of the following INS responses are checked:

* Response # 4. This document appears valid and relates to an

alien who has an application pending for: This response

will be checked when an alien is pending a new immigration

status or change of immigration status. Note that

legalization (amnesty) and SAW applicants do not acquire a