Sample Parent Letter For Day Care Centers And Head Start - Child And Adult Care Food Program (Cacfp) Page 2

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SAMPLE PARENT LETTER FOR DAY CARE CENTERS AND HEAD START
REAPPLICATION: If you are not eligible now but have a decrease in household income, an increase in household
size, or become unemployed, fill out an application at that time. Participants having family members who become
unemployed are eligible for free or reduced-price meals during the period of unemployment, provided that the loss of
income causes the family income during the period of unemployment to be within the eligibility standards for those
meals.
GROSS INCOME GUIDELINES FOR REDUCED-PRICE MEALS
Effective from July 1, 2016 - June 30, 2017
Number in
Annual Gross
Monthly Gross
Twice Per
Every Two Weeks
Weekly Gross
Family
Income
Income
Month
Gross Income
Income
21,978
1,832
916
846
423
1
29,637
2,470
1,235
1,140
570
2
37,296
3,108
1,554
1,435
718
3
44,955
3,747
1,874
1,730
865
4
52,614
4,385
2,193
2,024
1,012
5
60,273
5,023
2,512
2,319
1,160
6
7
67,951
5,663
2,832
2,614
1,307
8
75,647
6,304
3,152
2,910
1,455
Each
Additional
+ 7,696
+ 642
+ 321
+ 296
+ 148
Family
Member
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies,
the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are
prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior
civil rights activity in any program or activity conducted or funded by USDA.
Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print,
audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits.
Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at
(800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program complaint of discrimination, complete the
USDA Program Discrimination Complaint
Form,
(AD-3027) found online at: , and at any USDA office, or write a letter
addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint
form, call (866) 632-9992. Submit your completed form or letter 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;
(2) fax: (202) 690-7442; or
(3) email:
program.intake@usda.gov.
This institution is an equal opportunity provider.
For information on the CACFP, visit the CSDE’s
CACFP
Web site or contact the
CACFP staff
in the
Connecticut State Department of Education, Bureau of Health/Nutrition, Family Services and Adult
Education, 25 Industrial Park Road, Middletown, CT 06457.
This document is available at
Connecticut State Department of Education  Revised June 2016  Page 2 of 2

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