Administration and Forms for CACFP

Programs > Child and Adult Care Food Program > Administration/Forms

FNS Instruction 796-2 and Tip Sheet

FNS Instruction 796-2 Financial Management - Child and Adult Care Food Program (CACFP)
Tip Sheet - Assessing Costs in the Child and Adult Care Food Program (CACFP)

CACFP Forms

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Form Name	Form Number	Program Name
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
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
Good Cause Transfer Request Form		CACFP - Adult Day Care
Micro-Purchase Log		CACFP - Adult Day Care
Small Purchase Log		CACFP - Adult Day Care
Excess Net Cash Resources Plan for CACFP/SFSP		CACFP - Adult Day Care
CACFP Serious Deficiency Process Notification Template Letters		CACFP - Adult Day Care
CACFP Serious Deficiency Process Notification Form		CACFP - Adult Day Care
Building for the Future - Black and White		CACFP - At-Risk Afterschool
Building for the Future - Color		CACFP - At-Risk Afterschool
CACFP - Centers Claim for Reimbursement - Site Level		CACFP - At-Risk Afterschool
CACFP Medical Statement Form		CACFP - At-Risk Afterschool
Child Nutrition Programs Waiver Request		CACFP - At-Risk Afterschool
Contracting Entity Request for Waiver of 15% Limit for Allowable Administrative Costs		CACFP - At-Risk Afterschool
F&N Complaint Form - English		CACFP - At-Risk Afterschool
F&N Complaint Form - Spanish		CACFP - At-Risk Afterschool
Gender Separation Exception Request Form		CACFP - At-Risk Afterschool
Permanent Agreement Between Sponsoring Organization and Child Care Site		CACFP - At-Risk Afterschool
Permanent Agreement Between Sponsoring Organization and Child Care Site - Sponsoring Organization Provides Meals/Snacks		CACFP - At-Risk Afterschool
Permanent Agreement Contracting Entity Specific Amendment - Name		CACFP - At-Risk Afterschool
Permanent Agreement Contracting Entity Specific Amendment - Programs		CACFP - At-Risk Afterschool
Pre-Award Civil Rights Compliance Review		CACFP - At-Risk Afterschool
Racial/Ethnic Participant Data Collection Prototype		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

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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.