Administration and Forms for CACFP

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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)

All requests pertaining to Information for Bid (IFB) and Contract for Purchased Meals should be emailed to: ifb.Bops@texasagriculture.gov

CACFP Forms

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Form Name	Form Number	Program Name
2025 - 2026 School Data for Area Eligibility	SCHOOL DATA	CACFP Forms
2024 - 2025 School Data for Area Eligibility	SCHOOL DATA	CACFP Forms
2024-2025 WIC Information English and Spanish	WIC	CACFP Forms
2026 Income Eligibility Guidelines for Determining Free and Reduced Price Benefits	H1625-A	CACFP Forms
2025-2026 WIC Information English and Spanish	WIC	CACFP Forms
2025 Income Eligibility Guidelines for Determining Free and Reduced-Price Benefits	H1625-A	CACFP Forms
Addendum - Option to Renew IFB and Contract for Purchased Meals (Adult Day Care)	IFB - RENEW ADC	CACFP Forms
Addendum - Option to Renew IFB and Contract for Purchased Meals (Child Care Center and Day Care Home)	IFB - RENEW CCC & DCH	CACFP Forms
Addendum - Option to Renew IFB and Contract for Purchased Meals (SFSP & At-Risk)	IFB - RENEW SFSP & AT-RISK	CACFP Forms
Amendment 1 to Permanent Agreement Between Sponsoring Organization and Adult Day Care Site	AMEND 1	CACFP Forms
Amendment 1 to Permanent Agreement Between Sponsoring Organization and Child Care Site	AMEND 1	CACFP Forms
Amendment 2 to Permanent Agreement Between Sponsoring Organization and Child Care Site	AMEND 2	CACFP Forms
Amendment 2 to Permanent Agreement Between Sponsoring Organization and Child Care Site - Sponsoring Organization Provides Meals/Snacks	AMEND 2	CACFP Forms
Annual Audit	AUDIT	CACFP Forms
Application for Texas Identification Number	AP-152	CACFP Forms
Building for the Future - Black and White		CACFP Forms
Building for the Future - Color		CACFP Forms
CACFP - Centers Claim for Reimbursement - Site Level		CACFP Forms
CACFP - DCH Claim for Reimbursement - Provider Level		CACFP Forms
CACFP Infant Feeding Preference		CACFP Forms
CACFP Invitation for Bid (IFB) and Contract for Purchased Meals (Child Care Center and At-Risk)	IFB - CCC AND AT-RISK	CACFP Forms
CACFP Meal Benefit Income Eligibility Form (Adult Care)		CACFP Forms
CACFP Meal Benefit Income Eligibility Form (Adult Care) - SPANISH		CACFP Forms
CACFP Meal Benefit Income Eligibility Form (Child Care)		CACFP Forms
CACFP Meal Benefit Income Eligibility Form (Child Care) in Spanish		CACFP Forms
CACFP Meal Benefit Income Eligibility Form Letter to Households - Tier II Day Care Homes		CACFP Forms
CACFP Meal Benefit Income Eligibility Form Letter to Households - Tier II Day Care Homes - in Spanish		CACFP Forms
CACFP Meal Benefit Income Eligibility Form Letter to Households (Adult Day Care) - NON-PRICING PROGRAM		CACFP Forms
CACFP Meal Benefit Income Eligibility Form Letter to Households (Adult Day Care) - NON-PRICING PROGRAM - SPANISH		CACFP Forms
CACFP Meal Benefit Income Eligibility Form Letter to Households (Child Care Centers) - NON-PRICING PROGRAM		CACFP Forms
CACFP Meal Benefit Income Eligibility Form Letter to Households (Child Care Centers) NON-PRICING PROGRAM - SPANISH		CACFP Forms
CACFP Meal Benefit Income Eligibility Form Letter to Provider - Tier I or Provider's Own Children		CACFP Forms
CACFP Meal Benefit Income Eligibility Form Letter to Provider Tier I or Provider's Own Children i- SPANISH		CACFP Forms
CACFP Medical Statement Form		CACFP Forms
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion for Covered Contracts	H2048	CACFP Forms
Certification Regarding Federal Lobbying	H2049	CACFP Forms
Child Nutrition Programs Waiver Request		CACFP Forms
Claim for Reimbursement Worksheet - Meals	H4502	CACFP Forms
Contracting Entity Request for Waiver of 15% Limit for Allowable Administrative Costs		CACFP Forms
Daily Meal Count and Attendance Record (At-Risk)	H1535-AT	CACFP Forms
Daily Meal Count and Attendance Record (Centers and Emergency Shelters)	H1535	CACFP Forms
Daily Meal Count, Attendance, and Meal Production Record (H1539)	H1539	CACFP Forms
Daily Meal Production Record - Adult Day Care	H1654	CACFP Forms
Daily Meal Production Record - Child Care	H1530	CACFP Forms
Daily Meal Production Record - Infants	H1530-A	CACFP Forms
Direct Deposit Authorization	74-176	CACFP Forms
Documentation of Meals Claimed (Centers)	H1540	CACFP Forms
Documentation of Meals Claimed (Day Care Home Providers)	H1534	CACFP Forms
Documentation of Meals Claimed (At-Risk Sites)	H1540-AT	CACFP Forms
F&N Complaint Form - English		CACFP Forms

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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