Identity Verification Instructions
NEW YORK CITY DEPT. OF HEALTH AND MENTAL HYGIENE
Thank you for your recent order. Please be advised that New York City Dept. of Health and Mental
Hygiene requires the following identity verification documents to process your request.
Instructions For Gathering Required Documentation
You are required to submit a copy of your identification. Please gather a form
of identification from List A -or- two forms of identification from List B below. If
there is an address on your ID, it must match the shipping address.
List A - only ONE document is required:
List B - Two documents are required:
(No expired documents accepted. Must OR
(Must include address)
include signature.)
Driver's license or non-driver's license Utility bill and/or
from all states and U.S. territories Telephone bill and/or
IDNYC Municipal card Letter(s) from a City, State, or Federal
U.S. or foreign passport Government Agency
Public benefit card with photo
U.S. employment authorization card
Military ID card
Employee Photo ID with verifiable
employer and current pay stub
MTA reduced fare MetroCard
Student Photo ID and current transcript
from accredited and verifiable institution
Inmate photo ID with release papers
Photocopy your identification onto the attached Identity Verification Form, if
possible. If necessary, you may submit additional pages.
Sign and date the attached Identity Verification Form.
Submit your identification and the signed Identity Verification Form.
Instructions are provided on the following page.
Identity Verification Instructions
NEW YORK CITY DEPT. OF HEALTH AND MENTAL HYGIENE
Instructions For Submitting Your Documentation
OPTION 1: Using a SCANNER
1. Scan the documents that you gathered in the steps on the previous page.
2. Be sure the following information is visible on digital images of identification: Full
name and address, signature, license or identification number, and expiration date.
3. Ensure the scanned documents are saved to one or more files on your computer.
Only the following file formats can be accepted: bmp, gif, jpg or jpeg, tiff, and pdf.
4. Visit the 'Manage My Order' page on [Link]:
[Link]
5. Enter your order number: 116047303 and PIN: 234399
6. Select ‘Upload Documents Now’ under #2 on the ‘Completing Your Order’ page
7. Select the scanned image file(s) that you wish to upload
8. Attach the scanned image file(s) to your order
OPTION 2: Using a DIGITAL CAMERA or CAMERA PHONE
1. Take a picture of each document that you gathered in the steps on
the previous page.
2. Be sure the following information is visible on digital images of
identification: Full name and address, signature, license or
identification number, and expiration date
3. Upload or email the image(s) to your computer
4. Visit the 'Manage My Order' page on [Link]:
[Link]
5. Enter your order number: 116047303 and PIN: 234399
6. Select ‘Upload Documents Now’ under #2 on the ‘Completing Your
Order’ page
7. Select the uploaded image file(s) that you wish to upload
8. Attach the uploaded image file(s) to your order
OPTION 3: Submitting by FAX (ONLY if you cannot use option 1 or 2 above).
You should only use the fax option if you are unable to use Option 1 or 2 above.
Faxes are often rejected by government agencies because they are not legible.
Faxed documentation also has to be manually linked to your order, which
increases the processing time.
1. Use the attached Identity Verification Form as your Fax Cover Sheet.
2. Make sure all photocopies are legible. Copies of photo identification should be
enlarged by approximately 200%, and lightened by 2 shades.
3. Be sure the following information is visible on digital images of identification: Full
name and address, signature, license or identification number, and expiration date
4. Fax the Identity Verification Form and any other documentation to (866)-283-0617.
116047303
Identity Verification Form
NEW YORK CITY DEPT. OF HEALTH AND MENTAL HYGIENE
P.O. Box 1703
Brentwood, TN 37024-1703
Identity Verification Form
Applicant Name: Jaden Velez Order Date: 10/26/2020 08:18 PM CDT
Certificate Holder Name: Jaden Jassir Velez Order Number: 116047303
Contact Phone: (813)-580-3640 Order Pin: 234399
Contact Email: Knvng.b3bo@[Link] Agency Fax Number: (866)-283-0617
IMPORTANT
Once your documentation is received, it will be reviewed within 2 business days. Please wait AT LEAST 2 business days
before contacting our office for a status. You will be notified via email (if provided) once your documentation has been
approved. You may also visit the 'Manage My Order' page on [Link] for real-time order status (order number and
PIN are required).
Signature and Date Required
Applicant's Signature: Date:
