Department for Children and Families Agency of Human Services
Economic Services Division
280 State Drive [fax] 802-241-0460
Waterbury, VT 05671-1020 [toll free] 800-479-6151
Last Updated: 03/16/22
Examples of Acceptable Verification
Below you will find types of documentation we may require and examples of what you could
provide. If possible, please provide copies of the documentation you submit, instead of
originals. These are examples and not complete lists.
If you are unsure what to provide or have any questions, please call the Benefit Service Center
at 1-800-479-6151 for assistance.
• Identification
o A license, government-issued identification, birth certificate or passport. A photo ID is
preferred but not required
• Social security numbers for all members applying for assistance. If you don’t have a social
security number, we can help you apply for one.
• Income
o All gross wages received by your family in the 30 days before your application. Pay stubs
or written statements from employers. We need to see the pay dates, pay frequency,
hourly rate or salary and gross wages for each pay date.
• Self-employment
o If self-employed, most recent federal income tax return including all W2s, forms, and
schedules or record books showing income and expenses for the last 12 months or since
the business started whichever is less.
• Income you receive from renting a room and/or providing room and meals
o A written statement from any person paying you for room, room and meals, or only
meals.
• Income you receive from providing dependent care to children or adults in your home
o Federal tax return including all schedules, self-employment records or statement from
person paying. Also note the number of snacks, and the number and type of meals you
provide unless you receive reimbursement for them.
• Unearned income
o Social security award letter, SSI award letter, veteran’s benefits award letter,
unemployment or worker’s compensation statement, pensions statement, dividends
statement, or child support award letter, divorce/separation papers or statement from
person paying support, 1099.
• Dependent care expenses you paid in the last calendar month
o Receipts from daycare center or signed statement (including contact phone number)
from in-home daycare provider.
• Alimony or child support payments you made to anyone outside your household
o A court order, cancelled checks, or signed statement from the person receiving payment.
• Saving accounts, checking accounts, credit union accounts
o Account numbers or statements of all accounts, including children’s accounts.
• IRAs and profit-sharing accounts
o Statements showing dividends or payments.
• Rent receipt, lot rent receipt, rent lease agreement
• Proof of mortgage payment
o Recent mortgage statement
• Verification a household member is not deceased
o Written statement from you or someone in the household, paystub
• Verification a household member is no longer incarcerated
o Paystub, written statement from landlord or employer, written statement from
probation/parole officer, release paperwork
