Form Fns-252-2 - Usda Supplemental Nutrition Assistance Program Application For Meal Services
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7OMB APPROVED NO. 0584-0008
Expiration Date: 08/31/2017
USDA Supplemental Nutrition Assistance Program
FOR USDA USE ONLY
FNS Number:
Application for Meal Services
Date Authorized:
Authorization Initials:
Sponsor Type:
County Code:
Part 1 - Meal Service Types
Directions: Review the descriptions below and check the meal service type that describes the meal service.
You may only check one box (one meal service type) per application.
Private For-Profit Restaurant means private for-profit establishments that contract with an
Private For-Profit Restaurant
appropriate State or local agency to offer meals at concessional prices to homeless
individuals, elderly persons and their spouses or supplemental security income (SSI)
Franchise
Yes
No
recipients and their spouses.
Private Nonprofit
Drug and/or Alcohol Treatment Program means any drug addiction or alcoholic
Organization/Institution
treatment and rehabilitation program conducted by a private nonprofit organization or
institution, or a publicly operated community mental health center, that is operating under
Publicly Operated
part B of Title XIX of the Public Health Service Act (42 U.S.C. 300x et. seq.).
Organization/Institution
Public Meal Delivery
Meal Delivery Service or Private For-Profit Meal Delivery Service means a public or a
private organization that prepares and delivers meals to elderly persons and their spouses
Private For-Profit Meal Delivery
and/or to the physically or mentally handicapped and persons otherwise disabled, and their
spouses if they are unable to adequately prepare all of their meals.
Private Nonprofit Meal Delivery
Public Communal Facility
Communal Dining Facility means a public or private nonprofit establishment that prepares
and serves meals for elderly persons and their spouses or for SSI recipients and their
Private Nonprofit
spouses.
Communal Facility
Homeless Meal Provider means a public or private nonprofit establishment (e.g., soup
Public Establishment
kitchen, temporary shelter), approved by an appropriate State or local agency, that feeds
Private Nonprofit
homeless persons. If the site receives donated food items from USDA, the site must also
Establishment
purchase and serve other food.
Shelter for Battered Women and Children means a public or private nonprofit residential
Public Facility
facility that serves meals or provides food to battered women and children. If such a facility
Private Nonprofit Facility
serves other individuals, part of the facility must be set aside on a long-term basis to serve
battered women and children.
Group Living Arrangement means a public or private nonprofit residential setting that
Public Facility
serves no more than 16 residents and that is certified by the appropriate State agency(ies)
in accordance with 1616(e) of the Social Security Act or standards determined by USDA to
Private Nonprofit Facility
be comparable.
Private For-Profit Senior Citizens' Center or Residential Building means a facility that
Senior Citizens Center
prepares and serves meals to elderly or SSI recipients. Participating residential buildings
Residential Building
must be occupied primarily by elderly or SSI recipients.
You need to complete a separate FNS-252-2 application for each type of meal service you operate.
SBU
FORM FNS-252-2 (07-14) Previous Editions Obsolete
Electronic Form Version Designed in Adobe 10.0 Version
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