Forms

All Program Forms

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Form Name Form Number Form Download Form Download (Alternative Format) Instructions Download Program Name
Good Cause Transfer Request Form Download File Download File CACFP - Adult Day Care
Good Cause Transfer Request Form Download File Download File CACFP - At-Risk Afterschool
Good Cause Transfer Request Form Download File Download File CACFP - Child Care Center
Good Cause Transfer Request Form Download File Download File CACFP - Day Care Home
Governing Body Awareness GBA Download File Download File CACFP - Adult Day Care
Governing Body Awareness GBA Download File Download File CACFP - At-Risk Afterschool
Governing Body Awareness GBA Download File Download File CACFP - Child Care Center
Governing Body Awareness GBA Download File Download File CACFP - Day Care Home
Hazard Analysis Critical Control Point (HACCP) Checklist FND-104 Download File Download File School Nutrition Program Forms
Hiring Program Director Checklist Download File Download File School Nutrition Program Forms
Household Application for USDA Foods/Solicitud domestica de los alimentos del USDA H1555 Download File Download File Download File TEFAP Forms
Household Application for USDA Foods-Alternate H1555B Download File Download File Download File TEFAP Forms
Household Application for USDA Foods-Alternate (Spanish) H1555B Download File Download File Download File TEFAP Forms
Household Contact Download File CACFP - Child Care Center
Household Contact Download File CACFP - Day Care Home
Income and Categorical Application Checklist Download File Download File School Nutrition Program Forms
Income and Categorical Application Checklist Download File Download File Special Milk Program Forms
Income from Food Service Operations Form Download File Download File School Nutrition Program Forms
Informal Small Purchase Log Download File Download File School Nutrition Program Forms
Instructions for Authorization to Transfer USDA Foods H4529 Download File CSFP Forms
Instructions for Authorization to Transfer USDA Foods H4529 Download File Download File FDP Forms
Instructions for Authorization to Transfer USDA Foods H4529 Download File Download File School Nutrition Program Forms
Instructions for Authorization to Transfer USDA Foods H4529 Download File Download File TEFAP Forms
Instructions for Authorization to Transfer USDA Foods for Further Processing H4529.1 Download File Download File FDP Forms
Invitation for Bid and Contract for Purchased Meals IFB - ADC Download File Download File CACFP - Adult Day Care
Letter of Determination - Pricing Programs H1663 Download File Download File CACFP - Adult Day Care
Letter to Household - Eligibility Determination - Multiple Templates Download File School Nutrition Program Forms
Letter to Household - Eligibility Determination - Multiple Templates (SPANISH) Download File School Nutrition Program Forms
Letter to Household, Eligibility Based on Free Milk Application Download File Special Milk Program Forms
Letter to Household, Eligibility Based on Free Milk Application - Spanish Download File Special Milk Program Forms
List of Eligible Federal/State Funded Assistance Programs (Tier II Day Care Homes) H1660 Download File Download File Download File CACFP - Day Care Home
Local Wellness Policy (LWP) Checklist Download File Download File School Nutrition Program Forms
Meal Accommodation Tracking Form Download File Download File School Nutrition Program Forms
Media Release for Free Milk Sample Download File Special Milk Program Forms
Media Release for Free Milk Sample - SPANISH Download File All Program Forms
Media Release for Free Milk Sample - SPANISH Download File Special Milk Program Forms
Medical Statement Sample Form Download File Download File School Nutrition Program Forms
Micro-Purchase Log Download File Download File All Program Forms
Micro-Purchase Log Download File Download File CACFP - Adult Day Care
Micro-Purchase Log Download File Download File CACFP - At-Risk Afterschool
Micro-Purchase Log Download File Download File CACFP - Child Care Center
Micro-Purchase Log Download File Download File CACFP - Day Care Home
Micro-Purchase Log Download File Download File CSFP Forms
Micro-Purchase Log Download File Download File School Nutrition Program Forms
Micro-Purchase Log Download File Download File SFSP Forms
Micro-Purchase Log Download File Download File TEFAP Forms
Milk Flexibility for Emergency Conditions Notification Download File All Program Forms
Milk Flexibility for Emergency Conditions Notification Download File CACFP - At-Risk Afterschool
Milk Flexibility for Emergency Conditions Notification Form Download File CACFP - Adult Day Care
Milk Flexibility for Emergency Conditions Notification Form Download File CACFP - Child Care Center
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Assistance available in English and Spanish. Please call 877-TEX-MEAL (877-839-6325) for help. Additional translations services available as well.

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/ad-3027.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:

1. Mail:
U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410; or
2. Fax: (833) 256-1665 or (202) 690-7442; or
This institution is an equal opportunity provider.
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