Complete when the claimant's residence address differs from their mailing address or when there is a representative payee. Enter the state and county. We need this information to determine the correct amount of state payments and to establish categorical Medicaid eligibility. When the state of residence is not clear, see SI 01410.001 Eligibility for State Supplementary Payments, through SI 01410.050 Public Contact About State and County of Residence.

NOTE: If the claimant owns a home in another state and we are excluding that home as the principal place of residence because of intent to return, use the state where that home is located.

Use a mailing address to which the U.S. Post Office can deliver mail per SM 01005.400.

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  SM 01005.420 RA Field: Residence Street Address or Box Number If Different From “AD” Field

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  MSOM MSSICS 010.002 Residence Address (LRES)