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Form Name	Form Number	Program Name
Review	H1606-AT	CACFP - At-Risk Afterschool
SFSP and At-Risk Invitation for Bid (IFB) and Contract for Purchased Meals	IFB - SFSP AND AT-RISK	CACFP - At-Risk Afterschool
Sponsoring Organization Disbursement Record	H4503	CACFP - At-Risk Afterschool
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement		CACFP - At-Risk Afterschool
Milk Flexibility for Emergency Conditions Notification		CACFP - At-Risk Afterschool
Good Cause Transfer Request Form		CACFP - At-Risk Afterschool
Micro-Purchase Log		CACFP - At-Risk Afterschool
Valid At-Risk Unaffiliated Site Questionnaire/Attestation		CACFP - At-Risk Afterschool
Small Purchase Log		CACFP - At-Risk Afterschool
Excess Net Cash Resources Plan for CACFP/SFSP		CACFP - At-Risk Afterschool
CACFP Serious Deficiency Process Notification Template Letters		CACFP - At-Risk Afterschool
CACFP Serious Deficiency Process Notification Form		CACFP - At-Risk Afterschool
2021 - 2022 School Data for Area Eligibility	SCHOOL DATA	CACFP - Child Care Center
2022 - 2023 School Data for Area Eligibility	SCHOOL DATA	CACFP - Child Care Center
2024-2025 WIC Information English and Spanish	WIC	CACFP - Child Care Center
2025 Income Eligibility Guidelines for Determining Free and Reduced Price Benefits	H1625-A	CACFP - Child Care Center
2023-2024 WIC Information English and Spanish	WIC	CACFP - Child Care Center
2024 Income Eligibility Guidelines for Determining Free and Reduced-Price Benefits	H1625-A	CACFP - Child Care Center
Addendum - Option to Renew IFB and Contract for Purchased Meals CCC & DCH	IFB - RENEW CCC & DCH	CACFP - Child Care Center
Amendment 1 to Permanent Agreement Between Sponsoring Organization and Child Care Site	AMEND 1	CACFP - Child Care Center
Annual Audit	AUDIT	CACFP - Child Care Center
Application for Texas Identification Number	AP-152	CACFP - Child Care Center
Building for the Future - Black and White		CACFP - Child Care Center
Building for the Future - Color		CACFP - Child Care Center
CACFP - Centers Claim for Reimbursement - Site Level		CACFP - Child Care Center
CACFP Infant Feeding Preference		CACFP - Child Care Center
CACFP Invitation for Bid (IFB) and Contract for Purchased Meals	IFB - CCC AND DCH	CACFP - Child Care Center
CACFP Meal Benefit Income Eligibility Form (Child Care)		CACFP - Child Care Center
CACFP Meal Benefit Income Eligibility Form (Child Care) in Spanish		CACFP - Child Care Center
CACFP Meal Benefit Income Eligibility Form Letter to Households (Child Care Centers)		CACFP - Child Care Center
CACFP Meal Benefit Income Eligibility Form Letter to Households (Child Care Centers) in Spanish		CACFP - Child Care Center
CACFP Medical Statement Form		CACFP - Child Care Center
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion for Covered Contracts	H2048	CACFP - Child Care Center
Certification Regarding Federal Lobbying	H2049	CACFP - Child Care Center
Child Care Food Program Collection Procedures	H4515-A	CACFP - Child Care Center
Child Nutrition Programs Waiver Request		CACFP - Child Care Center
Claim for Reimbursement Worksheet - Meals	H4502	CACFP - Child Care Center
Contracting Entity Request for Waiver of 15% Limit for Allowable Administrative Costs		CACFP - Child Care Center
Daily Meal Count and Attendance Record (At-Risk)	H1535-AT	CACFP - Child Care Center
Daily Meal Count and Attendance Record (Centers and Emergency Shelters)	H1535	CACFP - Child Care Center
Daily Meal Production Record - Child Care	H1530	CACFP - Child Care Center
Daily Meal Production Record - Infants	H1530-A	CACFP - Child Care Center
Direct Deposit Authorization	74-176	CACFP - Child Care Center
Documentation of Meals Claimed	H1540	CACFP - Child Care Center
F&N Complaint Form - English		CACFP - Child Care Center
F&N Complaint Form - Spanish		CACFP - Child Care Center
Food Service Management Company/Vendor Monitor Review	H1529	CACFP - Child Care Center
Free and Reduced-Priced Meal Policy Statement (For Contractors that Charge Separately for Meals)	H4515	CACFP - Child Care Center
Gender Separation Exception Request Form		CACFP - Child Care Center
Governing Body Awareness	GBA	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

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

This institution is an equal opportunity provider.