S.D. Admin. R. 44:90:02:04

Current through Register Vol. 51, page 67, December 16, 2024

Section 44:90:02:04 - Patient registry identification card application requirements - Initial application

To apply for a patient registry identification card, a South Dakota resident with a debilitating medical condition, or the person responsible for making medical decisions for that person, shall submit to the department:

(1) A completed application on a form supplied by the department that must contain all information required by SDCL 34-20G-29 and 34-20G-33;

(2) A photocopy of an unexpired form of identification acceptable for voter identification pursuant to SDCL 12-18-6.1;

(3) A photograph meeting all the following requirements:

(a) A high resolution color photo that is not blurry, grainy, pixelated, or digitally altered;

(b) Uses a clear image of the individual's face without filters;

(c) Uses a plain white or off-white background;

(d) Is two by two inches in size;

(e) Is printed on matte or glossy photo quality paper; and

(f) Is not damaged with holes, creases, or smudges;

(4) If a low-income resident, documentation of household income, including:

(a) If employed, the resident's wage stubs or earning statements for the past 30 days;

(b) If self-employed, the resident's most recent federal income tax return and self-employment ledgers;

(c) Proof of all other income of the resident, including Social Security, Supplemental Security Income, workers' compensation, unemployment benefits, Bureau of Indian Affairs general assistance, child support, rental income, veterans' benefits, pensions, and interest income, for the previous 12 months; and

(d) The most recent financial statement from any of the resident's checking accounts, savings accounts, certificates of deposit, credit union account, retirement account, stock, bond, or dividend; and

(5) The required fee, pursuant to § 44:90:02:17.

S.D. Admin. R. 44:90:02:04

48 SDR 040, effective 10/5/2021

General Authority: SDCL 34-20G-72(4)(10)(c).

Law Implemented: SDCL 34-20G-29, 34-20G-72(4)(10)(c).