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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

Form NameForm NumberForm
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2020 - 2021 School Data for Area Eligibility  SCHOOL DATA Download File        SFSP Forms
2021 - 2022 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

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
 
This institution is an equal opportunity provider.
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