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Form DHCS0011 Proof of Acceptable Citizenship or Identity Documents - California (Hmong)
This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California.
The document is provided in Hmong. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DHCS0011 Proof of Acceptable Citizenship or Identity Documents?A: DHCS0011 is a form required by the California Department of Health Care Services (DHCS) to provide proof of acceptable citizenship or identity documents.
Q: Who needs to fill out DHCS0011?A: Any individual who is applying for or currently receiving health care benefits in California and needs to provide proof of their citizenship or identity needs to fill out DHCS0011.
Q: What is the purpose of DHCS0011?A: The purpose of DHCS0011 is to verify the citizenship or identity of individuals applying for or receiving health care benefits in California.
Q: What documents can be used as proof of acceptable citizenship or identity?A: Acceptable documents for proof of citizenship or identity include a U.S. passport, U.S. birth certificate, Certificate of Naturalization, Certificate of Citizenship, Permanent Resident Card, Employment Authorization Document, or valid foreign passport with visa and I-94 arrival/departure record.
Q: When do I need to submit DHCS0011?A: DHCS0011 needs to be submitted when you apply for health care benefits in California or when requested by the DHCS for existing recipients.
Q: What happens if I don't submit DHCS0011?A: Failure to submit DHCS0011 or provide acceptable proof of citizenship or identity may result in a denial of health care benefits or termination of existing benefits.
Q: Can I submit copies of my citizenship or identity documents?A: Yes, you can submit copies of your citizenship or identity documents with DHCS0011. However, the copies must be clear, legible, and unaltered.
Q: Can I provide documents in Hmong language?A: No, DHCS0011 requires that the documents be provided in English. If you have documents in another language, you may need to provide certified translations.
Q: Is DHCS0011 specific to the Hmong community?A: No, DHCS0011 is not specific to the Hmong community. It is a general form used by the California DHCS for all individuals applying for or receiving health care benefits.
Form Details:
- Released on June 1, 2008;
- The latest edition provided by the California Department of Health Care Services;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
Download a printable version of Form DHCS0011 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
