Cacfp meal benefit income eligibility form july 2011-2026

1. Click ‘Get Form’ to open it in the editor.
2. In Part 1, list the names of all household members, including the enrolled child(ren). If applicable, check the box for foster children and skip to Part 5.
3. For Part 2, if any household member receives SNAP, TANF, or FDPIR benefits, provide their name and case number. If not, proceed to Part 3.
4. In Part 3, if applicable, indicate any benefits received from eligible programs by providing the program name and case number. Check the box if no case number is available.
5. Part 4 requires you to report total household gross income. List each member with income and specify amounts received from various sources such as work earnings or social security.
6. Finally, in Part 5, an adult must sign the form and provide their last four digits of Social Security Number or indicate they do not have one. Ensure all information is accurate before submission.

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