23 MAC Pt. 102, R. 2.6
Documentary Evidences of U.S
Cite as 23 Miss. Admin. Code Pt. 102, R. 2.6
Documentary Evidences of U.S. Citizenship
A. Applicants declaring to be U.S. citizens whose citizenship cannot be verified by means of
electronic verification must provide acceptable evidence(s) of citizenship and identity.
B. Primary Evidence has the highest reliability. If provided, no further verification is needed to
verify citizenship and identity. If any other level of evidence is used to verify U.S. citizenship,
a second document verifying identity must be obtained. The following documents are accepted
as primary evidence:
1. U.S. Passport. A U.S. Passport does not have to be currently valid to be accepted as
evidence of U.S. citizenship as long as it was originally issued without limitation. On an
emergency basis, the passport office will issue a U.S. passport without proof of citizenship.
In this instance, the passport is issued with the limitation that is valid for one (1) year rather
than the usual five (5) or ten (10) years. When the holder of a passport with limitation
returns to the country, the holder has to provide proof of citizenship to have the passport
reissued without limitation. To determine if a passport was issued with limitation, compare
the issuance date with the expiration date. If the expiration date is less than five (5) years
from the issuance date, the passport was issued with limitation and cannot be used as proof
of citizenship. Each passport must be examined closely to determine whether or not the
passport was issued with limitation. Spouses and children were sometimes included on one
passport through 1980. U.S. passports issued after 1980 show only one person. The
citizenship and identity of the included person can be established when one of these
passports is presented. Passports issued with a limitation cannot be accepted as evidence
of U.S. citizenship. However, such a passport may be used as proof of identity.
2. Certificate of Naturalization (N-550 or N-570). Issued by Department of Homeland
Security (DHS) for Naturalization.
3. Certificate of Citizenship (N-560 or N-561). Issued by DHS to individuals who derive
citizenship through a parent.
4. A valid state-issued driver’s license, if the state issuing the license requires proof of U.S.
citizenship or obtains and verifies a Social Security Number from the applicant who is a
citizen before issuing such license.
5. Documentary evidence issued by a federally-recognized Indian Tribe, including Tribes
located in a state that has an international border, which:
a) Identifies the federal- recognized Indian Tribe that issued the document,
b) Identifies the individual by name, and
c) Confirms the individual’s membership, enrollment or affiliation with the Tribe, such
as:
1) A Tribal enrollment card,
2) A Certificate of Degree of Indian Blood,
3) A Tribal census document, or
4) Other document on Tribal letterhead issued under the signature of the appropriate
Tribal official that identifies the individual’s name and confirms the individual’s
membership, enrollment or affiliation with the federally-recognized Indian Tribe.
d) An updated listing of federally-recognized Indian Tribes is published annually in the
Federal Register by the Bureau of Indian Affairs within the U.S. Department of the
Interior.
6. A data match with the Social Security Administration (SSA).
C. Secondary Evidence of citizenship is documentary evidence of satisfactory reliability that is
used when primary evidence of citizenship is not available within the reasonable opportunity
period. In addition, a second document establishing identity must be presented. The following
documents are accepted as secondary evidence of citizenship:
1. A U.S. public birth record. A birth certificate may be issued by a state, commonwealth,
territory, or local jurisdiction showing birth in one of the following:
a) One of the fifty (50) U.S. States;
b) District of Columbia;
c) American Samoa;
d) Swain’s Island;
e) Puerto Rico (if born on or after January 13, 1941);
f) U.S. Virgin Islands (on or after January 17, 1917);
g) Northern Mariana Islands (after November 4, 1986, NMI local time); Guam (on or after
April 10, 1899).
2. Verification through the Department of Homeland Security’s Systematic Alien
Verification for Entitlements (SAVE) database to verify U.S. citizenship for a naturalized
citizen when original naturalization papers are not available.
3. When a child derives U.S. citizenship from a parent and meets the requirements of the
Child Citizenship Act of 2000, establish the parent’s U.S. citizenship and the child’s legal
immigration status, if applicable, through SAVE to verify the child’s citizenship. Primary
verification through a Certificate of Citizenship should be available if child was issued a
visa rather than a permanent resident alien card upon entry into the country.
4. Certification of Report of Birth Abroad (FS-1350). The U.S. Department of State issues a
DS-1350 to U.S. citizens who were born outside the U.S. and acquired citizenship at birth,
as verified by the information recorded on the FS-240, Consular Report of Birth Abroad.
When the birth was recorded on the FS-240, certified copies of the Certification of Report
of Birth Abroad can be obtained from the U.S. Department of State. The DS-1350 contains
the same information as recorded on the current version of the Consular Report of Birth
FS-240. The DS-1350 is not issued overseas and can be obtained from the U.S. Department
of State in Washington, D.C.
5. Consular Report of Birth Abroad of a Citizen of the United States of America (FS-240).
The Department of State consular office prepares and issues this document. A Consular
Report of Birth can only be prepared at an American consular office overseas, while the
child is under eighteen (18). While original FS-240s are not issued within the U.S., lost or
mutilated documents can be replaced through the U.S. Department of State in Washington,
D.C. Children born to military personal are usually issued an FS-240.
6. Certification of Birth Abroad (FS-545). Before November 1, 1990, the U.S. Department of
State consulates also issued Form FS-545 along with the prior version of FS-240. In 1990,
U.S. consulates ceased to issue Form-545. A FS-545 is the equivalent of a DS-1350 for
Medicaid eligibility purposes.
7. Certificate of Birth in the U.S. This is the form created by the birthing hospital that is sent
to Vital Records and used to create an official birth certificate.
8. U.S. Citizen ID Card (I-197) or prior version I-179. The former Immigration and
Naturalization Service (INS) issued the I-179 from 1960 until 1973. It revised the form and
renumbered it as form I-197. INS issued the I-197 from 1973 to April 7, 1983. INS issued
the form I-179 and I-197 to naturalized U.S. citizens living near the Canadian or Mexican
Border who needed it for frequent border crossings. Although neither form is currently
issued, either form that was previously issued is still valid.
9. Northern Mariana Card. INS issued the I-873 to a collectively naturalized citizen of the
U.S. who was born in the NMI before November 4, 1986. The card is no longer issued, but
those previously issued are still valid.
10. Final adoption decree. The adoption decree must show the child’s name and U.S. place of
birth. In situations where an adoption is not finalized and the state in which the child was
born will not release a birth certificate prior to final adoption, a statement from a state-
approved adoption agency that shows the child’s name and U.S. place of birth is acceptable.
The adoption agency must state in the certification that the source of the place of birth
information is an original birth certificate.
11. Evidence of civil service employment by the U.S. government. The document must show
employment by the U.S. government before June 1, 1976.
12. Official military record of service. The document must show a U.S. place of birth (for
example a DD-214 or similar official document showing a U.S. place of birth).
13. Verification with a State vital statistics agency documenting record of birth.
D. Third-Level Evidence of citizenship is documentary evidence of satisfactory reliability that is
used when primary or secondary evidence of citizenship is not available. Third-level evidence
may only be used when primary and secondary evidence does not exist or cannot be obtained
and the applicant/beneficiary alleges being born in the U.S. In addition, a second document
establishing identity must be obtained. The following are third-level evidences of citizenship:
1. Medical records, including but not limited to, hospital, clinic or doctor records or admission
papers from a nursing facility or other institution that indicates a U.S. place of birth.
Souvenir “birth certificates” issued by a hospital are not acceptable evidence.
2. Life or health or other insurance record that shows a U.S. place of birth.
3. Official religious record recorded in the U.S. showing that the birth occurred in the U.S.
The record must be an official record with a religious organization. In questionable cases,
e.g., a religious document recorded near an international border, the religious record must
be verified and/or verify that the mother was in the U.S. at the time of birth. Entries in a
family Bible are not considered religious records.
4. School records, including pre-school, Head Start and daycare, showing a U.S. place of
birth. The record must show the name of the child, the date of admission to the school, the
date of birth (or age at the time record was created), and a U.S. place of birth.
E. Fourth-Level Evidence of citizenship is of lowest reliability and is used in the rarest of
circumstances. It is used when primary evidence is not available, both secondary and third-
level evidence do not exist or cannot be obtained within the reasonable opportunity period and
the applicant alleges a U.S. place of birth. In addition, a second document establishing identity
must be obtained. Accept any of the following documents as fourth-level evidence of U.S.
citizenship if the document meets the listed criteria, the applicant/beneficiary alleges U.S.
citizenship and there is nothing indicating the person is not a U.S. citizen or lost U.S.
citizenship. Fourth-level evidence consists of documents established for a reason other than to
establish U.S. citizenship and showing a U.S. place of birth. The U.S. place of birth on the
document and documented place of birth on the application must agree. The written affidavit
may be used only when the specialist is unable to secure evidence of citizenship in any other
chart. The following are fourth-level verifications:
1. Federal or state census record showing U.S. citizenship or a place of birth (generally for
persons born 1900 through 1950). The census record must also show the applicant’s age.
Census records from 1900 to 1950 contain certain citizenship information. To secure this
information for the applicant, beneficiary, or state, complete Form BC-600, Application
for Census records for Proof of Age, place the note, “U.S. Citizenship data requested,” in
the remarks portion of the form, and indicate that the purpose is for Medicaid eligibility.
This form requires a fee.
2. Written Affidavit. An affidavit signed by another individual under penalty of perjury who
can reasonably attest to the applicant’s citizenship can be submitted with the applicant’s
name, date of birth and place of U.S. birth. The affidavit does not have to be notarized.
F. If the document used to verify U.S. citizenship indicates the individual was born in Puerto
Rico, the Virgin Islands of the U.S., or the Northern Mariana Islands before these areas became
part of the U.S., the individual may be a collectively naturalized citizen. Collective
naturalization occurred on certain dates listed for each territory.
1. Puerto Rico. Evidence of birth in Puerto Rico on or after April 11, 1899, and the
applicant/beneficiary’s statement that the applicant/beneficiary was residing in the U.S.
possession of Puerto Rico on January 13, 1941, or evidence that the applicant/beneficiary
was a Puerto Rican citizen and the applicant/beneficiary’s statement that the
applicant/beneficiary did not take an oath of allegiance to Spain.
2. U.S. Virgin Islands. Evidence of birth in the U.S. Virgin Islands and the
applicant/beneficiary’s statement of residence in the U.S., a U.S. possession or the U.S.
Virgin Islands on February 25, 1927. The applicant/beneficiary’s statement indicating
resident in the U.S. Virgin Islands as a Danish citizen on January 17, 1917, and residence
in the U.S., a possession or the U.S. Virgin Islands on February 25, 1927, and that the
applicant/beneficiary did not make a declaration to maintain Danish citizenship; or
evidence of birth in the U.S. Virgin Islands and the applicant/beneficiary’s statement
indicating residence in the U.S., a U.S. possession or territory or the Canal Zone on June
28, 1932.
3. Northern Mariana Islands (NMI), formerly part of the trust territory of the Pacific Islands
(TTPI). Evidence of birth in the NMI, the U.S., or a U.S. territory or possession on
November 3, 1986 (NMI local time) and the applicant/beneficiary’s statement that the
applicant/beneficiary did not owe allegiance to a foreign state on November 4, 1986, (NMI
local time); evidence of TTPI citizenship, continuous residence in the NMI since before
November 3, 1981 (NMI local time), voter registration prior to January 1, 1975, and the
applicant/beneficiary’s statement that the applicant/beneficiary did not owe allegiance to a
foreign state on November 4, 1986 (NMI l local time); or evidence of continuous domicile
in the NMI since before January 1, 1974, and the applicant/beneficiary’s statement that the
applicant/beneficiary did not owe allegiance to a foreign state on November 4, 1986 (NMI
local time). If a person entered the NMI as a nonimmigrant and lived in the NMI since
January 1, 1974, this does not constitute continuous domicile, and the individual is not a
U.S. citizen.