(CA) - Program - Based Qualification - Acceptable Documentation

Supplemental Security Income (SSI)

• Social Security Administration-issued notices
• Notice of Award
• Notice of Planned Action Benefit Verification
• Notice of Change in Payment

• The applicant's name

• The phrase “Supplemental Security Income (SSI)”

• A date not more than three-hundred sixty-five (365) calendar days prior to the date the TPA receives the application and supporting documents

• A monthly SSI monetary benefit greater than $0.00

Social Security Administration (SSA) Benefit Verification Letters 

Important Note: Documents must specifically identify the type of benefit received. Only Supplemental Security Income(SSI) counts as a program. All other payments, including this one, count as Income.

Social Security Administration Benefit Verification Letter content that DOES establish “program-based” qualification for California Lifeline 

Social Security Administration Benefit Verification Letter content that DOES NOT establish “program-based” qualification for California Lifeline

Section 8 [Public Housing Assistance Program] 

• Federal Public Housing or Section 8 notice of approval 
• Section 8 Housing Choice voucher 
• Housing Assistance Payment contract with a future expiration date
• No Need to match the applicant's address for program proof

Must Display:

• The applicant's name

• A Notice Date not more than three hundred sixty-five (365) calendar days
prior to the date the TPA receives the application and supporting documents

• The name of the qualifying program

• The name of the entity or agency which issued the document

LEASE AGREEMENT

Tribal Temporary Assistance for Needy Families [Tribal TANF]

Acceptable Documents: 

• Notice of Approval

• Notice of Grant Award

• Notice of Planned Action

• Tribal TANF Benefit Verification

Must Display:

• The applicant's name

• The phrase “TANF”

• A notice date not more than three hundred sixty-five (365) calendar
days prior to the date the TPA receives the application and supporting documents

• A monthly Tribal TANF monetary benefit greater than $0.00

• The name of the federally recognized Tribe or Tribal agency which issued the document 

Food Distribution Program on Indian Reservations [FDPIR]

Acceptable Documents must Display:  

• The applicant's name

• A notice date not more than three hundred sixty-five (365) calendar days
prior to the date the TPA receives the application and supporting documents

Federal Veterans Pension and Survivors Pension Benefit [VPSPB]

Acceptable Documents:

• Notice of Approval

• Notice of Pension Award

• Notice of Planned Action

• Benefit Verification

Must Display:

• The applicant's name

• The phrase “Veterans Pension” or “VA Survivors Pension”

• A notice date not more than three hundred sixty-five (365) calendar days
prior to the date the TPA receives the application and supporting documents

• A monthly pension monetary benefit greater than $0.00

• The notice must be issued by the U.S. Department of Veteran Affairs

A VA disability compensation is not a qualifying program for California LifeLine 

A California resident who receives VA disability compensation as a result of service-connected disabilities might qualify
based on income

* VA disability compensation can only be used as income proof if the amount is qualified. 

Low Income Home Energy Assistance Program [LIHEAP] or HEAP [Home Energy Assistance Program]

Acceptable Documents Must:

• Display the acronym "LIHEAP" or "HEAP“

• Be an image of a letter from the applicant’s home energy provider which displays the LIHEAP or HEAP discount amount, or an image of a home energy monthly billing statement which displays the LIHEAP or HEAP discount amount

• Display an issuance date not more than three-hundred sixty-five (365) calendar days prior to the date the TPA receives the application and supporting documents

• Display the name of the applicant

National School Lunch Program [NSLP]

Acceptable Documents:

• Notice of Approval
• Student with Free or Reduced Meals statement
• Notice on school letterhead confirming NLSP participation

Must Display:

• The applicant's name
• A notice date not more than three- hundred sixty-five (365) calendar days prior to the date the TPA receives the application and supporting documents

Key words/phrases Displayed by Documentation:

• NSLP

• California’s Universal Meals Program

*P-EBT is not acceptable as documentation of NSLP program participation. It can be rejected as WRONG DOCUMENT.

*Document should have the Parent/ Guardian’s name with matching address.

Includes:

• CalWORKs [California Work Opportunity and Responsibility to Kids]
• StanWORKs [Stanislaus Work Opportunity and Responsibility to Kids]
• Welfare-to-Work [WTW]
• Greater Avenues for Independence [GAIN]

Acceptable Documents:

• Notice of Approval
• Notice of Grant Award
• Notice of Planned Action
• Verification of Aid

Must Display:

• The applicant's name

• The phrase “TANF”

• A notice date not more than three-hundred sixty-five (365) calendar days prior to the date the TPA receives the application and supporting documents

Tribal Head Start Program

ROSEBUD SIOUX TRIBE HEAD START

Here are the following articles for information specific to:

Medi-Cal : (https://gen-mobile.tawk.help/article/me),

WIC : (https://gen-mobile.tawk.help/article/ca-wic-qualification),

and Calfresh/SNAP : (https://gen-mobile.tawk.help/article/calfresh-or-supplemental-nutrition-assistance-program-snap)