These links contain prototype forms with required information that must be provided to households and day care home providers:
- Letter to Households: Child Day Care and Tier II Providers and Adult Day Care
- Letter to Tier I and Family Day Care Home Providers
- Meal Benefit Income Eligibility Form: Child Day Care and Adult Day Care (with Instructions)
Note: States are not required to use the attached prototypes, but must ensure that the information is provided.
Meal Benefit Income Eligibility Form - English
Arabic | Greek | Kurdish | Samoan | Thai |
Armenian | Gujarathi | Laotian | Serbian | Tigrinya |
Chinese Simplified | Hindi | Mien | Somali | Traditional Chinese |
Creole | Hmong | Polish | Spanish | Ukrainian |
Croatian | Japanese | Portuguese | Sudanese | Urdu |
Farsi | Khmer | Punjabi | Tagalog | Vietnamese |
French | Korean | Russian |