Administration and Forms for CACFP

CACFP Forms

Minimize
Form Name Form Number Form Download Form Download (Alternative Format) Instructions Download Program Name
2021 - 2022 School Data for Area Eligibility SCHOOL DATA Download File CACFP - Day Care Home
2022 - 2023 School Data for Area Eligibility SCHOOL DATA Download File CACFP - Day Care Home
2024-2025 WIC Information English and Spanish WIC Download File CACFP - Day Care Home
2025 Income Eligibility Guidelines for Determining Free and Reduced Price Benefits H1625-A Download File CACFP - Day Care Home
2023-2024 WIC Information English and Spanish WIC Download File CACFP - Day Care Home
2024 Income Eligibility Guidelines for Determining Free and Reduced-Price Benefits H1625-A Download File CACFP - Day Care Home
Addendum - Option to Renew IFB and Contract for Purchased Meals CCC & DCH IFB - RENEW CCC & DCH Download File Download File CACFP - Day Care Home
Annual Audit AUDIT Download File Download File CACFP - Day Care Home
Application for Texas Identification Number AP-152 Download File CACFP - Day Care Home
Building for the Future - Black and White Download File CACFP - Day Care Home
Building for the Future - Color Download File CACFP - Day Care Home
CACFP - DCH Claim for Reimbursement - Provider Level Download File Download File Download File CACFP - Day Care Home
CACFP Infant Feeding Preference Download File Download File CACFP - Day Care Home
CACFP Invitation for Bid (IFB) and Contract for Purchased Meals IFB - CCC AND DCH Download File Download File CACFP - Day Care Home
CACFP Meal Benefit Income Eligibility Form (Child Care) Download File Download File CACFP - Day Care Home
CACFP Meal Benefit Income Eligibility Form (Child Care) in Spanish Download File Download File CACFP - Day Care Home
CACFP Meal Benefit Income Eligibility Form Letter to Households - Tier II Day Care Homes Download File CACFP - Day Care Home
CACFP Meal Benefit Income Eligibility Form Letter to Households - Tier II Day Care Homes - in Spanish Download File CACFP - Day Care Home
CACFP Meal Benefit Income Eligibility Form Letter to Provider - Tier I or Provider's Own Children Download File CACFP - Day Care Home
CACFP Meal Benefit Income Eligibility Form Letter to Provider Tier I or Provider's Own Children in Spanish Download File CACFP - Day Care Home
CACFP Medical Statement Form Download File Download File CACFP - Day Care Home
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion for Covered Contracts H2048 Download File Download File CACFP - Day Care Home
Certification Regarding Federal Lobbying H2049 Download File Download File CACFP - Day Care Home
Child Nutrition Programs Waiver Request Download File Download File CACFP - Day Care Home
Daily Meal Count, Attendance, and Meal Production Record (H1539) H1539 Download File Download File CACFP - Day Care Home
Daily Meal Production Record - Infants H1530-A Download File Download File CACFP - Day Care Home
Direct Deposit Authorization 74-176 Download File CACFP - Day Care Home
Documentation of Meals Claimed H1534 Download File Download File CACFP - Day Care Home
F&N Complaint Form - English Download File Download File CACFP - Day Care Home
F&N Complaint Form - Spanish Download File Download File CACFP - Day Care Home
Gender Separation Exception Request Form Download File CACFP - Day Care Home
Governing Body Awareness GBA Download File Download File CACFP - Day Care Home
Household Contact Download File CACFP - Day Care Home
List of Eligible Federal/State Funded Assistance Programs (Tier II Day Care Homes) H1660 Download File Download File Download File CACFP - Day Care Home
Notice to Providers of Tier Determination (Child and Adult Care Food Program-Day Care Homes) H1659 Download File Download File CACFP - Day Care Home
Payee Change Request 74-157 Download File CACFP - Day Care Home
Performance Bond BOND Download File CACFP - Day Care Home
Permanent Agreement Between Sponsoring Organization and Day Care Home Provider(s) Download File Download File Download File CACFP - Day Care Home
Permanent Agreement Contracting Entity Specific Amendment - Name Download File CACFP - Day Care Home
Permanent Agreement Contracting Entity Specific Amendment - Programs Download File CACFP - Day Care Home
Pre-Approval Visit H1607-P Download File Download File CACFP - Day Care Home
Pre-Award Civil Rights Compliance Review Download File Download File CACFP - Day Care Home
Racial/Ethnic Participant Data Collection Prototype Download File Download File CACFP - Day Care Home
Record of Leftover/Recycled Food H1568 Download File Download File CACFP - Day Care Home
Review H1607 Download File Download File CACFP - Day Care Home
Shared Eligibility Form Download File Download File CACFP - Day Care Home
Start Up or Expansion Payments Agreement Download File CACFP - Day Care Home
Start Up or Expansion Payments Application Download File Download File CACFP - Day Care Home
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement Download File CACFP - Day Care Home
Milk Flexibility for Emergency Conditions Notification Form Download File CACFP - Day Care Home
Page  1 of 5 First Previous [ 1 ] 2 3 4 5 Next Last

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.
SquareMeals.org Logo

Facebook Icon Instagram Icon
Twitter Icon YouTube Icon