Form Dhcs 0007 - California Acceptable Citizenship And Identity Documents (Tagalog) - Health And Human Services Agency Page 2

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State of California – Health and Human Services Agency
Department of Health Care Services
Para sa batang wala pang 16 na hindi nagbigay ng Sinumpaang
Isang Pasaporte ng Estados Unidos (inisyung may limitasyon)
Pahayag ng Pagiging Mamamayan, maaari kayong mag-sumite ng:
Sertipiko ng Katunayan ng Dugong Indiyan o iba pang
Isang Sinumpaang Pahayag ng pagkakakilanlan ng bata na
dokumento ng Tribung Amerikanong Indiyan/Katutubo ng Alaska
pinirmahan ng magulang, tagapag-alaga, o kamag-anak na
ng Estados Unidos
nag-aalaga na may kasamang petsa at lugar ng kapanganakan.
Kard ng Coast Guard Merchant Mariner ng Estados Unidos
Isang aplikasyon sa Medi-Cal o isang pinagsamang aplikasyon
Tatlo o mahigit na dokumentong nagpapatotoo, kagaya ng mga
sa Healthy Families/Medi-Cal na nagpapakita ng petsa at lugar
kard ng pagkakakilanlan ng empleyado, diploma sa kolehiyo o
ng kapanganakan ng bata, at pinirmahan ng magulang, tagapag-
mataas na paaralan, lisensiya sa kasal, atas ng diborsiyo, at
alaga o kamag-anak na nag-aalaga sa bata.
kasulatan/titulo ng ari-arian
Para sa batang wala pang 18, ang isang Sinumpaang Pahayag ng
Mga rekord sa klinika, doktor, o ng ospital para sa batang wala
pagkakakilanlan ng bata na pinirmahan ng magulang, tagapag-alaga,
pang 16
o kamag-anak na nag-aalaga ay maaaring gamitin kung hindi
Rekord ng paaralan, nursery school, o daycare, kabilang ang
makukuha ang mga kard ng pagkakakilanlan sa paaralan o lisensiya
mga report kard, para sa batang wala pang 16. Ang county ang
sa pagmamaneho.
magpapatunay sa paaralan.
Tala: Ang mga pasong dokumento ng pagkakakilanlan ay maaaring
Para sa mga taong may kapansanan na nakatira sa pasilidad ng
tanggapin na katunayan ng pagkakakilanlan.
pangangalagang pantahanan, ang isang Sinumpaang Pahayag
na pinirmahan ng direktor o tagapangasiwa ng pasilidad
DHCS 0007 (12/07) – Tagalog
Page 2 of 2

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