Immigration Documents Commonly Used by Lawfully Present Immigrants eligible for Coverage under the Affordable Care Act (ACA)

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Immigration Documents Commonly Used by Lawfully Present Immigrants eligible for Coverage under the Affordable Care Act (ACA) ***Remember: Authoritative documents from USCIS or DHS can also be acceptable forms of evidence for the purposes of ACA verifications. Category of Lawful Presence and Typical Documents Legal Permanent Resident (including Amerasians) Green card or passport stamp showing 1-551, AR-2, AR-3 Reentry permit I-327 Receipt from USCIS showing that I-90 app for LPR replacement card filed I-94 showing stamp for admission as LPR Order issued by DHS, BIA, immigration judge Applicant for LPR status (aka adjustment to LPR status) Receipt or notice showing filing or pending status of Form I-485 Form I-797 ASC Appointment notice with Case Type I-485 application I-797 receipt for application for EAD based on C09 I-512 authorization for parole, indicating applicant for adjustment of status Example of Commonly Used Immigration Document Current issue LPR card front and back Older version still in circulation filing or pending status of form I-485 Receipt showing Refugee I-94 Arrival or Departure Record stamped Refugee or I-94 Arrival or Departure Record stamped Refugee

207 Form I-688B or I-766A EAD Refugee travel document (I- 571) Conditional Entrant granted before 1980 Form I-94 or other document indicating status as conditional entrant, Seventh Preference, 203(a)(7) or P7 or 207 Asylee Form I-94 or passport stamped asylee or 208 Order granting asylum by USCIS, DHS, immigration judge, BIA or federal court Refugee travel document (I- 571) Granted Withholding of Deportation/Removal (including Orders granted under Convention Against Torture aka CAT) Order granting withholding of deportation/removal issued by USCIS, DHS, immigration judge, BIA or federal court I-688B I-766 EAD

Administrative order staying removal issued by DHS Applicant for Asylum or Withholding of Deportation/Removal, including applicants under CAT Receipt or notice showing filing or pending status of Form I-589 Cuban or Haitian Entrant Form I-94 with stamp indicating Cuban/Haitian entrant or any other notation indicating parole Any document indicating a pending asylum application, including a receipt for form I- 589 receipt Example of USCIS I-94 example

Paroled into the U.S. Form I-94 indicating parole or PIP or 212(d)(5) or other language indicating parole status NOTE: If later adjusted to LPR status, may have I-551 card Temporary Protected Status (TPS) Form I-797 Notice of Action showing grant of TPS status I-94 example Blank upper portion of an I-797 Notice of Action Applicant for TPS with Employment Authorization Receipt or notice showing filing or pending status of Form I-821 Example of a I-766 EAD Granted Deferred Enforced Departure (DED)

Granted Deferred Action Status Form I-797 Notice of Action or other form showing approval of deferred action status Example of I-797 Applicant for Special Immigrant Juvenile Status (SJIS) I-797 Notice of Action approval notice for SJIS Form I-797 Welcome Notice/Approval of I-485 I-551 green card I-551 coded SL6 Qualified Domestic Violence Survivor : pending petition under Violence Against Women Act (VAWA) or approval Receipt or other proof of filing I-130 visa petition Form I-360 Form I-797 Notice of Action referencing a pending I-360 Receipt or other proof of filing I-485 application for adjustment of status Any documents indicating a pending suspension of deportation or cancellation of removal case, including a receipt from an immigration court indicating filing of form EOIR-40 or EOIR-42 Blank I-360

Victim of Trafficking Certification from Office of Refugee Resettlement (ORR) ORR eligibility letter if under 18 Certification status verified through U.S. Dept of Health and Human Services Trafficking Verification Line (866)-401-5510 I-914 (T visa application) I-766 codes (a)(16) Form I-797 approval notice or extension of T or U nonimmigrant status I-512 authorization for parole I-551 green card Derivative Beneficiaries of Trafficking Survivors will have similar documents with T-# designations Nonimmigrant Statuses (letter visas aka U, S, V, etc.) Form I-94 or passport indicating admission to U.S. with nonimmigrant visa Proof of I-918 submission Receipt for form I-102 or I-918 I-797 approval notice I-688B or I-766 EAD Example of B1 visa found in passport

Citizen of Micronesia, Marshall Islands, and Palau Form I-94 or passport noted as CFA/RMI, CFA/FSM or CFA/PAL Form I-766 Lawful Temporary Resident Form I-688 Temporary Resident Card I-688A EAD I-668B or I-766 EAD Form I-698 Application to Adjust from Temporary to Permanent Residence under INA 245A I-94 example I-688 example

Applicant for Legalization under IRCA or the LIFE act with employment authorization I-688B or I-766 EAD Form I-687 Application for Temporary Residence under INA 245A Passport with a stamp or writing by INS/DHS officer, indicating pending 245A app Family Unity Form I-797 Notice of Action showing approval for I-817 application for Family Unity I-688B or I-766 EAD 687 Blank copy of I-

Applicant for Cancellation of Removal or Suspension of Deportation with employment authorization Receipt or notice showing filing Form EOIR-40, EOIR-42, or I-881 I-256A I-688B or I-766 EAD Order of Supervision with employment authorization Notice or form showing release under order of supervision I-881 Registry Applicant with employment authorization Receipt or notice showing filing Form I-485 Application to Register Permanent Resident or Adjust Status I-766 I-688B

Member of a federally-recognized Indian tribe or American Indian born in Canada Certificate from Department of Interior certifying Native American tribal ancestry or other authoritative document certificate Bureau of Indian Affairs Common Acronym Glossary: LPR: Legal Permanent Resident EAD: Employment Authorization Document USCIS: United States Citizenship and Immigration Service DHS: Department of Homeland Security BIA: Board of Immigration Appeals INS: Immigration and Naturalization Service (former USCIS) Developed by Legal Aid of San Mateo County/ San Mateo County Health System