Administration and Forms for Summer Meal Programs

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USDA SFSP Reference Materials/Sample Forms and TDA SFSP Forms

USDA’s SFSP Administrative Guidance for Sponsors (AGS) has a section titled Reference Materials where USDA has provided documents that can be used by contracting entities (sponsors) and sites. In addition, the USDA SFSP Sponsor Monitor’s Guide and the Nutrition Guide also have sample forms that can be used. You can find the USDA SFSP handbooks at http://www.fns.usda.gov/sfsp/handbooks. Forms provided by TDA for use in SFSP are available in the table below.

SFSP Forms

Form Name

Form Number

Form
Download

Instructions
Download

Program Name

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2021 - 2022 School Data for Area Eligibility

SCHOOL DATA

SFSP Forms

2022 - 2023 School Data for Area Eligibility

SCHOOL DATA

SFSP Forms

Addendum - Option to Renew IFB and Contract for Purchased Meals SFSP

IFB - RENEW SFSP

SFSP Forms

Addendum - Option to Renew IFB and Contract for Purchased Meals SFSP & At-Risk

IFB - RENEW SFSP & AT-RISK

SFSP Forms

Additional Assurances for Camps and Other Enrollment Programs that Charge Separately for Meals; Collection of Payment Options for Programs that Charge Separately for Meals

H1506-A

SFSP Forms

Application for Texas Identification Number

AP-152

SFSP Forms

Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion for Covered Contracts

H2048

SFSP Forms

Certification Regarding Federal Lobbying

H2049

SFSP Forms

Child Nutrition Programs Waiver Request

SFSP Forms

Daily Menu Production Worksheet

SFSP Forms

Direct Deposit Authorization

74-176

SFSP Forms

Disclosure of Lobbying Activities

SFSP Forms

Disclosure of Lobbying Activities Continuation Sheet

SFSP Forms

F&N Complaint Form - English

SFSP Forms

F&N Complaint Form - Spanish

SFSP Forms

Gender Separation Exception Request Form

SFSP Forms

Payee Change Request

74-157

SFSP Forms

Permanent Agreement Contracting Entity Specific Amendment - Name

SFSP Forms

Permanent Agreement Contracting Entity Specific Amendment - Programs

SFSP Forms

Pre-Award Civil Rights Compliance Review

SFSP Forms

Assistance available in English and Spanish. Please call 877-TEX-MEAL* (877-839-6325) for help.*
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.