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. 

If needed:

• 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.