Attachment 10 SFSP INCOME ELIGIBILITY FORM FOR THE SUMMER - education ky 2025

1. Click ‘Get Form’ to open it in the editor.
2. In Part 1, list the participant’s name and any SNAP, TANF, or FDPIR case number if applicable. If you have a case number, skip to Part 4.
3. For households with foster children, enter the child's name in Part 2 and contact the sponsor for further instructions.
4. In Part 3, report total household income from last month. List each member's name in Column A and their gross income in Column B along with how often it was received.
5. An adult must sign the form in Part 4 and provide the last four digits of their Social Security Number unless they do not have one.
6. Optionally complete Part 5 regarding participant’s ethnic and racial identities before submitting the form.

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