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The document is an Income Eligibility Application for the Child and Adult Care Food Program (CACFP) administered by the Tennessee Department of Human Services. It outlines the process for households to apply for meal reimbursements based on income eligibility for children enrolled in child care centers. The application includes sections for household information, income reporting, and optional sharing of data with Medicaid programs. It emphasizes the importance of accurate income reporting and provides guidance on how to complete the application, including definitions of household and eligibility categories.

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Versions	Form popularity	Fillable & printable
2011	4.9 Satisfied (253 Votes)

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