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All Program Forms

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Form Name	Form Number	Program Name
Direct Deposit Authorization	74-176	School Nutrition Program Forms
Direct Deposit Authorization	74-176	SFMNP Forms
Direct Deposit Authorization	74-176	SFSP Forms
Direct Deposit Authorization	74-176	Special Milk Program Forms
Direct Deposit Authorization	74-176	TEFAP 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
Payee Change Request	74-157	TEFAP Forms
Waiver	1	Special Milk Program Forms
F&N Complaint Form - English		All Program Forms
F&N Complaint Form - Spanish		All Program Forms
Participant Notification of SFSP Meals - Closed Enrolled Site - NON-AREA ELIGIBLE		All Program Forms
2023-2024 Standard (Multi-Child) Application for Free Milk - SPANISH		All Program Forms
Media Release for Free Milk Sample - SPANISH		All Program Forms
Verification Letter Sample Templates Suite - SPANISH		All Program Forms
Milk Flexibility for Emergency Conditions Notification		All Program Forms
Good Cause Transfer Request Form		All Program Forms
Micro-Purchase Log		All Program Forms
Unanticipated School Closure Notification Forms		All Program Forms
Sample Site Review Form - Non-Congregate/Hybrid Sites		All Program Forms
Pre-Award Civil Rights Compliance Review		All Program Forms
DoD Opt-in Form PY25-26		All Program Forms
DoD Opt-in Form PY25-26		All Program Forms
CACFP - Centers Claim for Reimbursement - Site Level		CACFP - Adult Day Care
CACFP Meal Benefit Income Eligibility Form (Adult Care)		CACFP - Adult Day Care
CACFP Meal Benefit Income Eligibility Form (Adult Care) in Spanish		CACFP - Adult Day Care
CACFP Meal Benefit Income Eligibility Form Letter to Households (Adult Day Care)		CACFP - Adult Day Care
CACFP Meal Benefit Income Eligibility Form Letter to Households (Adult Day Care) in Spanish		CACFP - Adult Day Care
CACFP Medical Statement Form		CACFP - Adult Day Care
Child Nutrition Programs Waiver Request		CACFP - Adult Day Care
Contracting Entity Request for Waiver of 15% Limit for Allowable Administrative Costs		CACFP - Adult Day Care
F&N Complaint Form - English		CACFP - Adult Day Care
F&N Complaint Form - Spanish		CACFP - Adult Day Care
Gender Separation Exception Request Form		CACFP - Adult Day Care
Permanent Agreement Between Sponsoring Organization and Adult Day Care Site		CACFP - Adult Day Care
Permanent Agreement Contracting Entity Specific Amendment - Name		CACFP - Adult Day Care
Permanent Agreement Contracting Entity Specific Amendment - Programs		CACFP - Adult Day Care
Pre-Award Civil Rights Compliance Review		CACFP - Adult Day Care
Racial/Ethnic Participant Data Collection Prototype		CACFP - Adult Day Care
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement		CACFP - Adult Day Care
Milk Flexibility for Emergency Conditions Notification Form		CACFP - Adult Day Care

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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.