Ein number tn dept of human services form 2026

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The document is the Tennessee Department of Human Services Form HS-1965A, which serves as an application for participation in the Child and Adult Care Food Program (CACFP). It outlines the requirements for sponsoring organizations to provide information about their organization, financial viability, budget details, administrative capabilities, program accountability, and compliance with civil rights regulations. The form includes sections for sponsor information, financial statements, budget estimates for operational and administrative costs, monitoring staff qualifications, and necessary certifications. It emphasizes the importance of fiscal accountability and adherence to federal and state regulations.

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Click ‘Get Form’ to open the ein number tn dept of human services form in the editor.
Begin with Section A, Sponsor Information. Fill in the name of your sponsoring organization and any alternate names. Enter your Agreement Number and Employer Identification Number (EIN). Ensure that your mailing address is complete, including city, state, and ZIP code.
Provide contact details for a designated person within your organization, including their phone number and email address. Select the type of organization from the provided options.
Answer the eligibility questions regarding disqualifications or convictions related to business integrity. Attach any necessary explanations if applicable.
Proceed to Section B for Financial Viability. Attach a comprehensive financial statement detailing your organization's income and expenditures for the last fiscal year.
In Section C, Budget, enter details about sponsored facilities and estimated reimbursements. Provide operational and administrative labor costs along with other necessary budget information.
Complete Sections D through N as required, ensuring all information is accurate and supported by necessary documentation before submitting.

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