Household Income Statements
Participation in Food and Nutrition Programs (FNS) involves an approval and verification process. Household eligibility forms and letters, family size/income guidelines, instructions and question-and-answer documents are all available to assist applicants in determining eligibility for participation. Documents on creating an enrollment list and reporting eligibility categories on the claim are also included.U.S. Department of Agriculture Memos
Links to key USDA memos on Household Income Statements are provided below. See the USDA Policy page for a complete set of USDA memos for the Child and Adult Care Food Program.
Child Enrollment Forms
Child enrollment information is required to be collected annually by child care centers participating in the Child and Adult Care Food Program. Attached are two versions of a form that may be used.
Household Income Eligibility Guidelines and Forms (Adult Care)
Household Income Statement form, Household Letter and income guidelines for approval of Child and Adult Care Food Program (CACFP) benefits at adult day care centers from July 1, 2013, through June 30, 2014.
Household Income Eligibility Guidelines and Forms (Child Care)
Household Income Statement form, Household Letter and income guidelines for approval of Child and Adult Care Food Program meal benefits at child care centers from July 1, 2013, through June 30, 2014.
Case Numbers Reported on Household Income Statements
Guidelines to identify eligible case numbers for Child and Adult Care Food Program (CACFP) benefits.
Extending Categorical Eligibility
Extending a child's categorical eligiblity for meal benefits to other children in the same household - May 2010 memo
Somali Child Enrollment Form
The Somali translation of the form to document the enrollment of children in the child care program.
Spanish Child Enrollment Form
The Spanish translation of the form to document the enrollment of children in the child care program.
Hmong Child Enrollment Form
The Hmong translation of the form to document the enrollment of children in the child care program.
Sharing Income Eligibility Information
Data on children qualified for meal benefits may be shared between organizations that administer federal child nutrition programs. For example, a school participating in the National School Lunch Program may share data on students eligible for free and reduced-price school meals with an organization that sponsors other federal child nutrition programs - February 2008.
Disclosure Requirements for the Child Nutrition Programs
Statutory and regulatory requirements for disclosure of information concerning children who are eligible for free or reduced-price meals.
Extending Categorical Eligibility to Additional Children in a Household
U.S. Department of Agriculture (USDA) memo modifying categorical eligibility policy for households receiving assistance under Food Assistance (Stamps), Food Distribution Program on Indian Reservations (FDPIR) or the Minnesota Family Investment Program
Verification Requirement for Centers with Separate Meal Charges
Procedures used to annually verify a sample of Household Income Statements that have been approved for free or reduced price meals - October 2002 memo.