Dma 5152-2025

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The document is a North Carolina Residency Declaration form used to verify an individual's residency in North Carolina. It requires the applicant's name, physical address, and a declaration of intent to reside or seek employment in the state. The form must be signed by a person with personal knowledge of the applicant's residency.

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2016	4 Satisfied (56 Votes)

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How do I prove NC residency?

Proving North Carolina Residency Any document issued by the state of North Carolina or a county or city in North Carolina or the federal government North Carolina Vehicle Registration Card, insurance policy or title. North Carolina Voter Precinct Card. Military orders or military documents Utility bill or cable bill.

What counts as proof of address in North Carolina?

A current rental lease agreement, mortgage receipt, or current utility bill showing the North Carolina address.

What is proof of residency for NC Medicaid?

(1) A valid North Carolina drivers license or other identification card issued by the North Carolina Division of Motor Vehicles. (2) A current North Carolina rent or mortgage payment receipt, or current utility bill in the name of the applicant or the applicants legal spouse showing a North Carolina address.

What documents do I need for Medicaid in NC?

Prepare the following documents below for each person applying to help complete your application: Full legal name. Date of birth. Social Security number (or immigration documents) North Carolina residency. Income information (from paystubs, W-2 forms, tax returns or business records)

How does Medicaid determine residency?

State residency for individuals who are not living in an institution and are age 21 or over is generally defined as the state in which the individual is living and intends to reside. An individual does not need to have a fixed address.

dma 5152

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What is an NC residency declaration?

This form is used to verify that, , is a. (Applicant(s) Name) Resident of North Carolina and resides at . (Physical Address)

What is NC DHHs DMA?

Division of Medical Assistance manages the North Carolina Medicaid and Health Choice for Children programs. Medicaid. provides health insurance for low-income children, families of dependent children, pregnant women, seniors, and.

Dma 5152-2025

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How do I prove NC residency?

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What documents do I need for Medicaid in NC?

How does Medicaid determine residency?

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What is an NC residency declaration?

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