Administration and Forms for Summer Meal Programs

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

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Form Name Form Number Form Download Form Download (Alternative Format) Instructions Download Program Name
2023 - 2024 School Data for Area Eligibility SCHOOL DATA Download File SFSP Forms
2022 - 2023 School Data for Area Eligibility SCHOOL DATA Download File SFSP Forms
Addendum - Option to Renew IFB and Contract for Purchased Meals SFSP IFB - RENEW SFSP Download File Download File SFSP Forms
Addendum - Option to Renew IFB and Contract for Purchased Meals SFSP & At-Risk IFB - RENEW SFSP & AT-RISK Download File Download File 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 Download File Download File Download File SFSP Forms
Application for Texas Identification Number AP-152 Download File SFSP Forms
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion for Covered Contracts H2048 Download File Download File SFSP Forms
Certification Regarding Federal Lobbying H2049 Download File Download File SFSP Forms
Child Nutrition Programs Waiver Request Download File Download File SFSP Forms
Daily Menu Production Worksheet Download File Download File Download File SFSP Forms
Direct Deposit Authorization 74-176 Download File SFSP Forms
Disclosure of Lobbying Activities Download File SFSP Forms
Disclosure of Lobbying Activities Continuation Sheet Download File SFSP Forms
F&N Complaint Form - English Download File Download File SFSP Forms
F&N Complaint Form - Spanish Download File Download File SFSP Forms
Gender Separation Exception Request Form Download File SFSP Forms
Payee Change Request 74-157 Download File SFSP Forms
Permanent Agreement Contracting Entity Specific Amendment - Name Download File SFSP Forms
Permanent Agreement Contracting Entity Specific Amendment - Programs Download File SFSP Forms
Pre-Award Civil Rights Compliance Review Download File Download File SFSP Forms
Prototype Letter: Health Department Notification Download File SFSP Forms
Racial/Ethnic Participant Data Collection Prototype Download File Download File SFSP Forms
Record of Leftover/Recycled Food H1568 Download File Download File SFSP Forms
SFSP - Claim for Reimbursement - Site Level Download File Download File Download File SFSP Forms
SFSP and At-Risk Invitation for Bid (IFB) and Contract for Purchased Meals IFB - SFSP AND AT-RISK Download File Download File SFSP Forms
SFSP Invitation for Bid (IFB) and Contract for Purchased Meals IFB - SFSP Download File Download File SFSP Forms
Shared Eligibility Form Download File Download File SFSP Forms
Temperature Record H1639 Download File Download File Download File SFSP Forms
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement Download File SFSP Forms
USDA Foods Agreement Between Contracting Entity and Texas Department of Agriculture Download File Download File SFSP Forms
Participant Notification of SFSP Meals - Closed Enrolled Site - AREA ELIGIBLE Download File SFSP Forms
Participant Notification of SFSP Meals - Closed Enrolled Site - NON-AREA ELIGIBLE Download File SFSP Forms
Participant Notification of SFSP Meals - Closed Enrolled Site - CAMP SITE Download File SFSP Forms
SFSP Household Application for Closed Enrolled and Camp Sites (Prototype) Download File SFSP Forms
Sample First Two Weeks Site Visit Form Download File SFSP Forms
Sample Site Review Form Download File SFSP Forms
Request to Provide Non-Congregate Feeding during Extreme Heat Download File SFSP Forms
Milk Flexibility for Emergency Conditions Notification Form Download File SFSP Forms
Micro-Purchase Log Download File Download File SFSP Forms
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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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