Documents Needed for Applications for Program Eligibility

Abbreviated Program Eligibility Checklist
Program Food Stamps
Medicaid Medical Care School Enrollment TANF Child-Only TANF Workforce LEAP WIC Colorado Child Care Assistance Program (CCCAP)
Required Documents
Completed Application tick tick
Enrollment Card tick tick tick tick tick
Proof of Identity/Citizenship
( Driver’s license, ID card. Birth certificate )
( Anyone on application-birth certificate for child )
( Child-birth certificate )
( Child-birth certificate if available )
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( Anyone on application-birth certificates and adult photo ID )
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Proof of Immigrant Status of Non-Citizens tick
Social Security Number tick
( Anyone on application )
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( Anyone on application )
Marriage Certificate tick
Proof of Residence
( Rental agreement, Mortgage statement, Rent receipt, Utility bill )
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( Adult )
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Proof of Monthly Income
( Paycheck stubs for last 30 days, Benefit letters from SSI or VA, Unemployment check stub, Pension information )
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( Adult )
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( Adult )
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(3 months of paycheck stubs needed and activity schedule must be verified)
Proof of Monthly Shelter Costs
( Lease/Mortgage payment book, Homeowner’s insurance bill, Property tax bill, All utilities )
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( Heat Bill )
Proof of Out of Pocket Childcare Expense
( Cancelled check, Bill with childcare provider’s name/address, Receipt )
Proof of Out of Pocket Medical Expenses for Elderly/Disabled tick
Proof of Resources
( Bank statement )
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( Adult )
Child in Person tick tick
Child’s Immunization Record(s) ( Helpful if new physician ) tick
( Must be available within 14 days of enrollment )
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Proof of Legal Decision-Making (Identified below
( Authorization type varies based on situation ) A checkmark in the shaded grey area refers to one of the types of authorization identified below.
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  • Custody Orders
    ( Ordered and signed by a judge )
  • Voluntary Agreement
    ( Private agreement between parent and caregiver is signed, witnessed, and notarized )
  • Voluntary Placement Agreement
    ( State form CWS-3 signed by parent and county department of human services )
  • Power of Attorney
    ( Signed and notarized )
Authorization for Medical Care
( Should be included in the types of decision-making identified above )
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