What to Bring to Your Interview

 Proof of Identity:

 Proof of Address (choose one below)     

•  NC Driver's license, learner's permit or state issued ID
•  Current utility bill with name and address
•  Bank statement with name and address 
•  NC voter registration card
• Current Social Services check or letter
• Current County/City billing statement
• Lease agreement or mortgage statement with the address of the residence, your name and your landlord's name and address
• Pay stubs with your name and address.
•  If you are homeless, your shelter must give us a letter, on letterhead, stating that you stay there

 Proof of expenses (choose all that apply)

 You must provide information on living expenses and debts, including cars in your household (please read important definitions section) and rent or mortgage, including:

•  Title, car registration or monthly bill for every car in the household.
•  A lease contract for apartment or house.
•  A mortgage statement or title for house.
•  Monthly bills, including power, cable, telephone, credit cards, car insurance, etc.

Proof of Income (All that apply)

 You are required to bring a copy of your last year's tax returns unless you did not file this form. However, please notice that in some cases the screener might ask you to obtain a letter from the IRS verifying that you did not file taxes the previous year.  Also note that some patients may be asked to provide a health care insurance verification form from your employer.

 Please bring the following additional information for each member of the household if it applies (please read important definitions section):

• HealthCare Access (formerly Doctors Care) identification card.  
•  A letter from a homeless shelter on letterhead stating your name and dates of residency.
• Copy of the last two pay stubs from every person who works in the household (please read important definitions section to know whose pay stubs you are required to bring).
• Proof of disability or retirement benefits (letter from SSI). If you have direct deposit for these checks, you must provide a bank statement and verification from SSI.
• If you are paid in cash, a Verification of Employment Form, which you can obtain at our reception desk, must be completed, signed and faxed by your employer. We may call your employer to verify your information.
• If you are self-employed and do not file tax returns, bring your accounting books or a record of state tax sales revenue for the past year.
•  If you are being supported by relatives or friends, we require a letter of support from the person who is helping you along with proof of her/his income to verify that they have enough income to support you.
• If you are being supported by an organization, we require a letter from the organization helping you on letterhead. 
•  If you are recently unemployed, bring your last two pay stubs and information about any unemployment compensation you will be receiving. 
•  If you are living on savings, you must provide three of your most recent bank statements.

Remember, you are invited to come to CCC to discuss your situation with one of our screeners who will try to help you through the application process.

Special requirements for children

     You also must bring for your child:

     Vaccination record

     Medicaid card (if your child is on Medicaid)

      Ages 5 -17 –school records with current address

 Important definitions:

Household: Defined as members of an immediate family living in the same residence. This includes parents, son, daughters, grandparents and children for whom the parents have legal custody. Children living in the same household as their parents, regardless of age, will be considered part of the household. Children who do not live with their parents may be included on an application if the parent can show that they support the child financially.

Proof of identity must be provided for each member of the household (including children) listed on the application. Others living in the house or apartment, such as sisters, brothers, aunts, uncles or friends must apply separately.

 Individual: A single person who lives alone or resides with others but does not qualify as a member of a household.

Emancipated child:  An individual 18 years of age or under who is unmarried and lives on their own without financial support from parents may apply as an individual.