Administration and Forms for SFMNP

SFMNP Forms

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Form Name Form Number Form Download Form Download (Alternative Format) Instructions Download Program Name
2022-2023 SFMNP Income Eligibility Guidelines H1668 Download File Download File SFMNP Forms
2023-2024 SFMNP Income Eligibility Guidelines H1668 Download File Download File SFMNP Forms
Annual Audit AUDIT Download File Download File SFMNP Forms
Application for Texas Identification Number AP-152 Download File SFMNP Forms
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion for Covered Contracts H2048 Download File Download File SFMNP Forms
Certification Regarding Federal Lobbying H2049 Download File Download File SFMNP Forms
Claim for Reimbursement Vouchers and Administrative Expenses Download File Download File Download File SFMNP Forms
Direct Deposit Authorization 74-176 Download File SFMNP Forms
Disclosure of Lobbying Activities Download File SFMNP Forms
Disclosure of Lobbying Activities Continuation Sheet Download File SFMNP Forms
F&N Complaint Form - English Download File Download File SFMNP Forms
F&N Complaint Form - Spanish Download File Download File SFMNP Forms
Farmers' Market Review Download File Download File SFMNP Forms
Farmers' Voucher Redemption List Download File Download File Download File SFMNP Forms
Participant Application - English H1430 Download File Download File Download File SFMNP Forms
Participant Application - Spanish H1430S Download File Download File Download File SFMNP Forms
Participant Voucher Issuance Log Download File Download File Download File SFMNP Forms
Payee Change Request 74-157 Download File SFMNP Forms
S/FMNP Farmers' Market, Roadside Stand, and Certification/Issuance Site Information Form H1420 Download File Download File SFMNP Forms
Senior Farmers' Market Nutrition Program Allowed-Disallowed Foods H1440 Download File Download File SFMNP Forms
SFMNP Agreement Between Contracting Entity and Famers’ Market Association SFMNP-03 Download File Download File SFMNP Forms
SFMNP Agreement Between Contracting Entity and Sub-Distributing Agency SFMNP-02 Download File Download File SFMNP Forms
SFMNP Agreement Between TDA and Contracting Entity SFMNP-01 Download File Download File SFMNP Forms
SFMNP Farmer Profile and Agreement Between Farmer and Farmers’ Market Association SFMNP-04 Download File Download File SFMNP Forms
SFMNP Farmer Profile and Bulk Purchase Agreement SFMNP-05 Download File Download File SFMNP Forms
SFMNP Site Review Download File Download File Download File SFMNP Forms
Vendor Integrity Evaluation Report Download File Download File Download File SFMNP Forms
Voucher Receipt Log H1451 Download File Download File Download File SFMNP 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
This institution is an equal opportunity provider.
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