Administration and Forms for SMP

Programs > Special Milk Program > Administration/Forms

Administration and Forms for SMP

TX-UNPS

SMP participants submit applications and file claims through the Texas Unified Nutrition Programs System: TX-UNPS. If you are unable to use an Internet-based application such as TX-UNPS, please contact TDA.

Application Frequently Asked Questions

2022-2023 Applications and Letters

Special Milk Program Forms

Enter Search Value:
- without any prefix or suffix to find all records where a column contains the value you enter, e.g. Net
- with | prefix to find all records where a column starts with the value you enter, e.g. |Network
- with | suffix to find all records where a column ends with the value you enter, e.g. Network|
- with | prefix and suffix to find all records containing the value you enter exactly, e.g. |Network|

Form Name	Form Number	Program Name
2022-2023 Application Letter to Household for Free Milk		Special Milk Program Forms
2022-2023 Income Eligibility Guidelines for Determining Free Milk Benefits		Special Milk Program Forms
2022-2023 Standard (Multi-Child) Application for Free Milk		Special Milk Program Forms
2023-2024 Income Eligibility Guidelines for Determining Free Milk Benefits		Special Milk Program Forms
Application for Texas Identification Number	AP-152	Special Milk Program Forms
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion for Covered Contracts	H2048	Special Milk Program Forms
Certification Regarding Federal Lobbying	H2049	Special Milk Program Forms
Child Nutrition Programs Waiver Request		Special Milk Program Forms
Cooler or Freezer Temperature Recording Form		Special Milk Program Forms
Direct Deposit Authorization	74-176	Special Milk Program Forms
F&N Complaint Form - English		Special Milk Program Forms
F&N Complaint Form - Spanish		Special Milk Program Forms
Income and Categorical Application Checklist		Special Milk Program Forms
Letter to Household, Eligibility Based on Free Milk Application		Special Milk Program Forms
Letter to Household, Eligibility Based on Free Milk Application - Spanish		Special Milk Program Forms
Media Release for Free Milk Sample		Special Milk Program Forms
Payee Change Request	74-157	Special Milk Program Forms
Permanent Agreement Contracting Entity Specific Amendment - Name		Special Milk Program Forms
Permanent Agreement Contracting Entity Specific Amendment - Programs		Special Milk Program Forms
Policy Statement for Special Milk Program, Attachment B: Milk Count/Collection Procedure(s)		Special Milk Program Forms
Scanned and Web-based Application Checklist, National School Lunch Program (NSLP), School Breakfast Program (SBP), and Special Milk Program (SMP)		Special Milk Program Forms
Special Milk Program Worksheet		Special Milk Program Forms
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement		Special Milk Program Forms
Waiver	1	Special Milk Program 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/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.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.