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New Verification Letter Sample Templates Suite (English and Spanish)

Published: 1 years 235 days ago
" TDA has released a new Verification Letters Sample Templates Suite (in both English and Spanish) that consolidates all verification notifications, information request forms, and verification results letters into an intuitive, single document of resources. The new Verification Letters Sample Templates Suite is located on the NSLP/SBP Administration/Forms page as well as the dedicated Application Verification page, where more information is provided on each individual template.
"
TDA has released a new Verification Letters Sample Templates Suite (in both English and Spanish) that consolidates all verification notifications, information request forms, and verification results letters into an intuitive, single document of resources. The new Verification Letters Sample Templates Suite is located on the NSLP/SBP Administration/Forms page as well as the dedicated Application Verification page, where more information is provided on each individual template. The following documents are now included in this consolidated document:
  • Verification Notification - Selection Letter for Households - Provides notification to households that their child’s household meal application has been randomly selected for verification of eligibility. 
  • Verification of Free and Reduced-Price Eligibility | Information for Households - Accompanies the Selection Letter for Households and provides those selected households with a detailed list of requested documentation based on their eligibility type.
  • Verification Information Request | Statement of Earnings Form - Intended to be used when households need to provide proof of income as part of the eligibility verification process. It is completed by the household member’s employer.
  • Verification Information Request | Statement of Social Security Income Form - Intended to be used when households need to provide proof of income as part of the eligibility verification process. It is completed by a Social Security office official. 
  • Notification of Verification Results - The Notification of Verification Results letter samples are intended to provide household notification of the CE’s verified determination of eligibility. The letters are intended to finalize the verification process and provide households with appropriate continuation of benefits or adverse action information based on the results of the CE’s determination. The following sample letters include:
- Continuation of Benefits Letter
- Results/Adverse Action Letter - Income
- Results/Adverse Action Letter - SNAP/TANF
- Results/Adverse Action - Foster
  • Verification Information Request | SNAP/TANF Multiple Applicant Letter and Form - Intended to be used during the verification process to assist the Contracting Entity (CE) in determining the eligibility of participants who have qualified for free meals based on household SNAP or TANF eligibility. This form is prepared by the CE, but verification is determined by the SNAP or TANF official.

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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, 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.
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