Administration and Forms for FMNP

FMNP Forms

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Form Name Form Number Form Download Form Download (Alternative Format) Instructions Download Program Name
Annual Audit AUDIT Download File Download File FMNP Forms
Application for Texas Identification Number AP-152 Download File FMNP Forms
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion for Covered Contracts H2048 Download File Download File FMNP Forms
Certification Regarding Federal Lobbying H2049 Download File Download File FMNP Forms
Claim for Reimbursement Download File Download File Download File FMNP Forms
Direct Deposit Authorization 74-176 Download File FMNP Forms
Disclosure of Lobbying Activities Download File FMNP Forms
Disclosure of Lobbying Activities Continuation Sheet Download File FMNP Forms
F&N Complaint Form - English Download File Download File FMNP Forms
F&N Complaint Form - Spanish Download File Download File FMNP Forms
Farmers' Market Nutrition Program Allowed-Disallowed Foods H1442 Download File Download File FMNP Forms
Farmers' Market Review Download File Download File FMNP Forms
Farmers' Voucher Redemption List Download File Download File Download File FMNP Forms
FMNP Agreement Between Contracting Entity and Famers’ Market Association FMNP-02 Download File Download File FMNP Forms
FMNP Agreement Between TDA and Contracting Entity FMNP-01 Download File Download File FMNP Forms
FMNP Agreement Between TDA and Contracting Entity – AMENDMENT FMNP-01A Download File Download File FMNP Forms
FMNP Farmer Profile and Agreement Between Farmer and Farmers’ Market Association FMNP-03 Download File Download File FMNP Forms
Participant Voucher Issuance Log Download File Download File FMNP Forms
Payee Change Request 74-157 Download File FMNP Forms
Plan of Operation H1406 Download File Download File Download File FMNP Forms
S/FMNP Farmers' Market, Roadside Stand, and Certification/Issuance Site Information Form H1420 Download File Download File FMNP Forms
Vendor Integrity Evaluation Report Download File Download File Download File FMNP Forms
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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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