Administration and Forms for CACFP

CACFP Forms

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Form Name Form Number Form Download Form Download (Alternative Format) Instructions Download Program Name
Permanent Agreement Contracting Entity Specific Amendment - Programs 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
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
Good Cause Transfer Request Form Download File Download File CACFP - Day Care Home
Micro-Purchase Log Download File Download File CACFP - Day Care Home
Small Purchase Log Download File Download File CACFP - Day Care Home
Excess Net Cash Resources Plan for CACFP/SFSP Download File CACFP - Day Care Home
CACFP Serious Deficiency Process Notification Template Letters Download File CACFP - Day Care Home
CACFP Serious Deficiency Process Notification Form Download File CACFP - Day Care Home
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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
This institution is an equal opportunity provider.
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