Form Dhcs 0006 - California Xav Tau Tej Puavpheej Uas Qhia Tias Yog Neeg Amelikas Lossis Neeg Ntawm Lub Tebchaws No - Health And Human Services Agency

ADVERTISEMENT

State of California – Health and Human Services Agency
Department of Health Care Services
Xav Tau Tej Puavpheej Uas Qhia Tias Yog Neeg Amelikas lossis
Neeg Ntawm Lub Tebchaws No
Rau Cov Neeg Thov thiab Cov Neeg Tau Txais Medi-Cal
Uas Yog Neeg Amelikas lossis Neeg Ntawm Lub Tebchaws No
Ib tsab kevcai tshiab hais tias yuav luag txhua tus neeg thov thiab tus neeg tau txais Medi-Cal uas yog neeg
Amelikas lossis neeg ntawm lub tebchaws no yuavtsum tau muaj tej puavpheej uas qhia tias nws yog neeg
Amelikas thiab puavpheej qhia tias nws yog leejtwg tiag. Thov muab cov uas khij hauv qab no tuaj tsis pub
dhau _________________.
Tus Neeg Thov lossis Neeg Tau Txais npe
(Npe – Npe nrab – Xeem):
Tus neeg no raug zam lossis muaj txhua yam lawm. Peb tsis xav tau puavpheej ntawm nws ntxiv lawm.
Thov muab puavpheej tias yog leejtwg tiag rau tus neeg no.
Thov muab puavpheej tias yog neeg Amelikas rau tus neeg.
Thov muab puavpheej tias yog neeg Amelikas thiab puavpheej tias yog leejtwg tiag rau tus neeg no.
Peb nrhiav tsis tau tus neeg no daim ntawv yug. Yog tus neeg no yug hauv xeev Kalifonias, thov ua Daim
Ntawv Thov Ntawv Yug hauv Kalifonias uas xa tuaj nrog no thiab muab xa rovqab tuaj rau peb.
Tus Neeg Thov lossis Neeg Tau Txais npe
(Npe – Npe nrab – Xeem):
Tus neeg no raug zam lossis muaj txhua yam lawm. Peb tsis xav tau puavpheej ntawm nws ntxiv lawm.
Thov muab puavpheej tias yog leejtwg tiag rau tus neeg no.
Thov muab puavpheej tias yog neeg Amelikas rau tus neeg.
Thov muab puavpheej tias yog neeg Amelikas thiab puavpheej tias yog leejtwg tiag rau tus neeg no.
Peb nrhiav tsis tau tus neeg no daim ntawv yug. Yog tus neeg no yug hauv xeev Kalifonias, thov ua Daim
Ntawv Thov Ntawv Yug hauv Kalifonias uas xa tuaj nrog no thiab muab xa rovqab tuaj rau peb.
Tus Neeg Thov lossis Neeg Tau Txais npe
(Npe – Npe nrab – Xeem):
Tus neeg no raug zam lossis muaj txhua yam lawm. Peb tsis xav tau puavpheej ntawm nws ntxiv lawm.
Thov muab puavpheej tias yog leejtwg tiag rau tus neeg no.
Thov muab puavpheej tias yog neeg Amelikas rau tus neeg.
Thov muab puavpheej tias yog neeg Amelikas thiab puavpheej tias yog leejtwg tiag rau tus neeg no.
Peb nrhiav tsis tau tus neeg no daim ntawv yug. Yog tus neeg no yug hauv xeev Kalifonias, thov ua Daim
Ntawv Thov Ntawv Yug hauv Kalifonias uas xa tuaj nrog no thiab muab xa rovqab tuaj rau peb.
Yog koj tsis muaj cov kev qhia uas hais saumtoj no, tabsis koj tseem tabtom nrhiav, thov qhia rau peb paub. Thov
qhia rau koj lub chaw pabcuam pejxeem hauv nroog, lossis ua daim ntawv Affidavit of Reasonable Effort to Get
Proof of Citizenship thiab muab xa rovqab tuaj rau peb.
Lub county mam ua lub npov no.
County fills out this box.
Case No:
Case Name:
DHCS 0006 (Hmong) (08/07)
Page 1 of 1

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Dhcs 4001 - California Programas De Acceso A La Salud Certificacion Para El Programa Family Pact Retroactiva De Elegibilidad (rec) - Health And Human Services Agency Form Dhcs 4001 - California Programas De Acceso A La Salud Certificacion Para El Programa Family Pact Retroactiva De Elegibilidad (rec) - Health And Human Services Agency Legal
Form Dhcs 0003 - California Daim Ntawv Teev Kev Nrhiav Tej Puavpheej Uas Qhia Tias Yog Neeg Amelikas - Health And Human Services Agency Form Dhcs 0003 - California Daim Ntawv Teev Kev Nrhiav Tej Puavpheej Uas Qhia Tias Yog Neeg Amelikas - Health And Human Services Agency Legal
Form Dhcs 4461 Sp - California Programas De Acceso A La Salud Para El Programa Family Pact Certificacion De Elegibilidad Del Cliente - Health And Human Services Agency Form Dhcs 4461 Sp - California Programas De Acceso A La Salud Para El Programa Family Pact Certificacion De Elegibilidad Del Cliente - Health And Human Services Agency Legal
Form Dhcs 7077 A - California Notice Regarding Transfer Of A Home For Both A Married And An Unmarried Applicant/beneficiary - Health And Human Services Agency Form Dhcs 7077 A - California Notice Regarding Transfer Of A Home For Both A Married And An Unmarried Applicant/beneficiary - Health And Human Services Agency Legal
Form Dhcs 0006 - California Proof Of Citizenship Or Identity Needed (armenian) - Health And Human Services Agency Form Dhcs 0006 - California Proof Of Citizenship Or Identity Needed (armenian) - Health And Human Services Agency Legal
Form Dhcs 0006 - California Proof Of Citizenship Or Identity Needed (arabic) - Health And Human Services Agency Form Dhcs 0006 - California Proof Of Citizenship Or Identity Needed (arabic) - Health And Human Services Agency Legal
Form Dhcs 0006 - California Proof Of Citizenship Or Identity Needed (laotian) - Health And Human Services Agency Form Dhcs 0006 - California Proof Of Citizenship Or Identity Needed (laotian) - Health And Human Services Agency Legal
Dhcs 0006 - California Proof Of Citizenship Or Identity Needed (korean) - Health And Human Services Agency Dhcs 0006 - California Proof Of Citizenship Or Identity Needed (korean) - Health And Human Services Agency Legal
Form Dhcs 0006 - California Proof Of Citizenship Or Identity Needed - Health And Human Services Agency Form Dhcs 0006 - California Proof Of Citizenship Or Identity Needed - Health And Human Services Agency Legal
Form Dhcs 0006 - California Proof Of Citizenship Or Identity Needed (vietnamese) - Health And Human Services Agency Form Dhcs 0006 - California Proof Of Citizenship Or Identity Needed (vietnamese) - Health And Human Services Agency Legal

Related Categories

Parent category: Legal
Download
Go