Information Needed to Apply
Proof that you live in Napa County, such as a utility bill or rental agreement with your current name and address listed.
Proof of income, with one of the following:
• Recent paycheck stub; previous year’s federal income tax return; written
statement from your employer stating gross monthly income and when it was earned; OR
• Persons paid in cash may complete and sign a form stating income
and when it was earned; OR
• Self-employed people may use the previous year’s
federal income tax return with Schedule C.
• Birth certificate • Proof of Income: most current check stub (1-2) AND/OR
Income Taxes 2020 with W-2 forms.
• Self-employed: Taxes 2020 Schedule C, E or other. • Not working: unemployment stubs and/or report of cash income
(keep in mind how much you have earned in cash and keep copies of payments by personal check or other).
• Birth Certificates for all children under 21 • Proof of address: Utility Bill, school mail, etc. • Applicant’s ID: California Driver’s License or Matricula Consular Mexicana • Social Security Cards for everyone who is applying including
the applicant even if not applying for coverage or ITIN
• If Pregnant, proof of pregnancy
If born outside of the U.S.:
• Legal Permanent Residents need to bring LPR card • Naturalized U.S. Citizens need to bring a U.S. passport
or Citizenship certificate.