Signatures| Commodities | Training
Food Service | Outreach | Appeals | Forms
New Non-school Sponsors
Summer Food Service Program
Application Packet
Program Year 2008
This page includes a list of forms that must be completed and submitted
to the Texas Department of Agriculture (TDA).
Please complete the required number of copies of these forms and submit
them to your Food and Nutrition Field Operations Office by April 15,
2008. (Click here to
find your Food and Nutrition Field Operations Office.)
This application packet contains a permanent agreement, which, hereafter,
will require that you provide only updated information to our office at the
beginning of the operation of your SFSP.
Note: TDA is prohibited from approving an SFSP application
submitted after June 15, 2008.
These forms can be downloaded three ways:
Note: Forms that are not contained in the Forms Section
of the Summer Food Service Program Handbook can be found in the
table below or in the downloadable PDF file mentioned above.
It is recommended that you keep a copy of all documents submitted with your
application.
If you or the person who will complete these
forms are not able to access the forms from the website, please call: (877) TEX-MEAL.
top of page Required Signatures
Only an Authorized Representative that has been authorized on a Form H4508,
Special Nutrition Programs Certificate of Authority, can sign program-related
documents for your organization.
top of page
USDA Food Commodities
To receive United States Department of Agriculture (USDA) donated commodities
you must complete the forms listed on the USDA
Donated Commodity forms page and submit them to your Food and Nutrition Field Operations Office.
These forms must be sent to your APO when
you submit your
SFSP Contract Application forms. If you have any questions about the
SFSP Commodity Application forms, please contact Ester Serna at (512)
420-2429
or by e-mail at Ester.Serna@tda.state.tx.us.
top of page
Required Training
All 2008 SFSP sponsors must receive program training before they can be
approved to operate their SFSP.
As a convenience to organizations interested in becoming an SFSP sponsor,
training sessions will be held in several cities across the state. Click
here for the 2008 SFSP Training Schedule. Please
refer to the instructions on that webpage about how to make your reservations
for the training session you and/or your
staff would like to attend.
Note: You will receive a
certificate verifying your completion of the required program training. You
must submit a copy of this certificate with your completed application.
top of page
Food Service Management Company
If your organization plans to contract with a
Food Service Management Company to provide SFSP meals, you must use Form
H1628, Summer Food Service Program Invitation for Bid and Contract, for each
bid solicitation. All federal and state contracting requirements must also be
adhered to. Please refer to Sections 4000 and 7000 in your SFSP Handbook for
detailed information.
top of page
Outreach Materials
SFSP information is available for you to use to conduct outreach for your SFSP. This poster can be
placed in locations in your community to create awareness about and increase
participation in your program. The poster contains the 24 hour statewide SFSP
Hotline telephone number, 2-1-1(Note: You must wait until after May 20,
2008 to call the 2-1-1 system for information about
the Summer Food Service Program operating in your area)
, that anyone can call to request information about the location of the
nearest SFSP feeding site. Please call: (877) TEX-MEAL to order a supply of SFSP Posters.
top of page
Appeal Rights
You
have the right to appeal any action by TDA that affects your participation in the SFSP, or your SFSP claim for reimbursement. Your
written request for an appeal must include the basis for the appeal of the adverse action, a copy of the adverse action letter and be received by TDA within 10 days of receipt of the adverse action notification. The phone number for contacting staff at the Appeals Division is (5120 463-4075. The written appeal request should be mailed certified mail, return receipt requested, or faxed to:
TDA Appeals
ATTN: John Wiley, Docket Clerk
Texas department of Agriculture
P.O. Box 12847
Austin, Texas 78711
You may hand-deliver or submit
your appeal request via overnight/special delivery service to the following
street address:
SFA Building, Room 1125E
1700 North Congress
Austin, Texas 78701
top of page
We
look forward to working with your organization in serving nutritious meals to
more children in Texas in Summer 2008.
Forms
Form |
Title of Form |
Number to Submit |
Instructions |
Attachment #1
|
Texas Department of Agriculture Food and Nutrition Division Filed Operations Office
(F&N FOO) |
|
|
Attachment #2
|
Copy of the SFSP Forms Table for New Non-Schools Sponsors |
|
|
Attachment #3
USDA Donated Commodity Forms Page
|
Copy of the USDA Donated Commodity Forms Table |
|
|
TDA Agreement
(July 2008)
|
Texas Department of Agriculture Food and Nutrition Division Agreement |
|
Two FND Agreements must be completed, signed with original signatures, and returned. A signed form will be returned to you after TDA approves your application and agreement. |
Form H1506
(January 2008) |
Application for Participation |
2 |
Two copies must be completed, signed with original signatures, and returned. A signed form will be returned to you after TDA approves your application. |
Form H1506 Attachment A
(January 2008) |
Additional Assurances for Camps and Other Enrollment Programs that Charge Separately for Meals |
2 |
Submit two copies if your organization will operate camps or other enrolled programs that charge separately for meals. |
Form H1506
Attachment B
(January 2008) |
Criminal Provisions and Penalties |
1 |
Submit one copy. |
Outreach Plan Attachment
(January 2002)
MS Word
PDF |
Application Outreach Plan for Open and Restricted Open Sites |
1 |
Complete and submit to your Food and Nutrition Field Operations Office. |
Form H1507
(January 2008) |
Site Information |
2 per site |
Submit original and one copy for each feeding site participating under your agreement. |
Form H1569
(July 2006) |
Single Audit Identification Data, for Program Year 2008 |
2 |
Submit an original and one copy. |
Form H1628
(January 2006) |
Invitation For Bid and Contract |
2 |
For organizations who plan to contract with a Food Service Management Company to provide SFSP meals. Submit an original and one copy for each solicitation for bids. |
Form H1510
(Januray 2008) |
First-Week Site Visit Waiver Request |
1 |
If you would like to request a waiver, complete and return original to your F&N FOO. |
Form H1570
(Januray 2007) |
Request for Waiver to Server More Than 25 Sites |
1 |
Private nonprofit sponsors only
If you would like to request a
waiver, complete and return
original to your F&N FOO. |
Form H1571
(January 2007) |
Request for Waiver of the 15 Consecutive School Day Requirement |
1 |
If you would like to request a waiver, complete and return original to your F&N FOO. |
Form H1572
(March 2007) |
Request for Waiver of Time Restrictions for Meal Services at an SFSP Site |
1 |
If you would like to request a waiver, complete and return original to your F&N FOO. |
Form H1573
(December 2007) |
Request For Waiver of Number and Type of Meals Served at an SFSP Site |
1 |
If you would like to request a waiver, complete and return original to your F&N FOO. |
Form H4508
(December 2007) |
Certificate of Authority |
2 |
Submit an original and one copy. Use this form to add, change, or delete Authorized Representatives. |
Form H4526
(December 2007) |
Pre-Award Compliance Review |
1 |
Complete and submit to your Food and Nutrition Field Operations Office. |
Form 74-176
(Rev. 4-05/4) |
Vendor Direct Deposit Authorization |
1 |
Complete and return with application. |
Form AP-152
(Rev. 1-07/9) |
Texas Application for Payee Identification Number |
1 |
Complete and return with application. |
Charitable Choice
MS Word
PDF |
Special Nutrition Program Charitable Choice Data Form |
1 |
Optional - Complete and return with application. |
Tax Exemption |
Proof of Tax Exemption (Non-Profit Organizations Only) |
1 |
If you are a Non-Profit Organization submit a copy of your IRS Tax Exemption Letter. |
Training Certificate |
Training Certificate verifying completion of required program training |
1 |
Submit a copy of your training certificate with your completed application. Keep the original for your files. |
top of page
Download all forms
You may download all the forms
in the table above in one PDF file. These forms must be printed and completed
by hand or on a typewriter, signed, and
returned to per the instructions in the table above. You cannot complete
the PDF forms online. This forms package is approximately 1,645 KB
in size.
top of page
Documents in PDF format require the use of the
free Adobe Reader, which can be downloaded from Adobe
Systems, Inc. You can also download the free Acrobat
Accessibility Reader for PDFs.
Updated:
March 5, 2008 |