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Proof of Residency Forms (Multiple Languages)
DC HealthCare Alliance (Alliance) is ONLY for people who live in Washington, DC If you are applying for medical assistance through the DC HealthCare Alliance, you must show that you are a DC resident.
You can show that you live in DC with:
- a valid DC driver’s license or ID card,
- a lease, rental receipt, deed, settlement papers, or mortgage statement for a DC residence, home owner’s or renter’s insurance policy,
- a property tax bill, a utility bill,
- a paystub showing address and DC taxes withheld,
- or a voter registration card showing your name and DC address.
If you do not have any of those documents, you can also prove that you live in DC using this form.
Another DC resident who knows where you live can verify your residency by filling out Section B, or a local non-profit social services provider can verify your residency in Section C.
If you need more information, read the Proof of Residency Frequently Asked Questions [PDF] (also available in multiple languages)