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Form Name	Form Number	Program Name
SFSP/SSO Meal Count Form - Non-Congregate Meal Bundling		SFSP Forms
2024-2025 Application Letter to Household for Free Milk		Special Milk Program Forms
2024-2025 Income Eligibility Guidelines for Determining Free Milk Benefits		Special Milk Program Forms
2024-2025 Standard (Multi-Child) Application for Free Milk		Special Milk Program Forms
2023-2024 Income Eligibility Guidelines for Determining Free Milk Benefits		Special Milk Program Forms
Child Nutrition Programs Waiver Request		Special Milk Program Forms
Cooler or Freezer Temperature Recording Form		Special Milk Program Forms
F&N Complaint Form - English		Special Milk Program Forms
F&N Complaint Form - Spanish		Special Milk Program Forms
Income and Categorical Application Checklist		Special Milk Program Forms
Letter to Household, Eligibility Based on Free Milk Application		Special Milk Program Forms
Letter to Household, Eligibility Based on Free Milk Application - Spanish		Special Milk Program Forms
Media Release for Free Milk Sample		Special Milk Program Forms
Permanent Agreement Contracting Entity Specific Amendment - Name		Special Milk Program Forms
Permanent Agreement Contracting Entity Specific Amendment - Programs		Special Milk Program Forms
Policy Statement for Special Milk Program, Attachment B: Milk Count/Collection Procedure(s)		Special Milk Program Forms
Scanned and Web-based Application Checklist, National School Lunch Program (NSLP), School Breakfast Program (SBP), and Special Milk Program (SMP)		Special Milk Program Forms
Special Milk Program Worksheet		Special Milk Program Forms
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement		Special Milk Program Forms
2024-2025 Application Letter to Household for Free Milk - SPANISH		Special Milk Program Forms
2024-2025 Standard (Multi-Child) Application for Free Milk - SPANISH		Special Milk Program Forms
Media Release for Free Milk Sample - SPANISH		Special Milk Program Forms
Disclosure of Lobbying Activities		TEFAP Forms
Disclosure of Lobbying Activities Continuation Sheet		TEFAP Forms
F&N Complaint Form - English		TEFAP Forms
F&N Complaint Form - Spanish		TEFAP Forms
Micro-Purchase Log		TEFAP Forms
Small Purchase Log		TEFAP Forms
TEFAP Agreement Between Contracting Entity and Site		TEFAP Forms
TEFAP Agreement Between Contracting Entity and Subdistributing Agency		TEFAP Forms
TEFAP Agreement Between Contracting Entity and Texas Department of Agriculture		TEFAP Forms
TEFAP Participant Rights and Responsibilities		TEFAP Forms
USDA Foods Complaint Form - English		TEFAP Forms
USDA Foods Complaint Form - Spanish		TEFAP Forms
Pre-Award Civil Rights Compliance Review		TEFAP Forms
Written Notice of Beneficiary Rights		TEFAP Forms
Written Notice of Beneficiary Rights - SPANISH		TEFAP Forms
Equipment Inventory Form		TEFAP Forms
Waiver	1	Special Milk Program Forms
Payee Change Request	74-157	CACFP - Adult Day Care
Payee Change Request	74-157	CACFP - At-Risk Afterschool
Payee Change Request	74-157	CACFP - Child Care Center
Payee Change Request	74-157	CACFP - Day Care Home
Payee Change Request	74-157	CSFP Forms
Payee Change Request	74-157	FDP Forms
Payee Change Request	74-157	FMNP Forms
Payee Change Request	74-157	School Nutrition Program Forms
Payee Change Request	74-157	SFMNP Forms
Payee Change Request	74-157	SFSP Forms
Payee Change Request	74-157	Special Milk Program Forms

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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

3. Email: program.intake@usda.gov.

This institution is an equal opportunity provider.