Automatic Eligibility:
*Budget Sheet or Benefit Card from the Department of Social
Services
(If a child is certifying, benefit card must be in the child’s
name)
*A letter from Head Start verifying that a child in the
household is enrolled in Head Start and stating that income guidelines were met.
*Letter showing eligibility for free/reduced priced lunch.
Or Income Guidelines equaling or less than the following
Guidelines include gross family income as well as the
following funds:
|
FAMILY SIZE |
ANNUAL |
MONTHLY |
WEEKLY |
|
1 |
20,036 |
1,670 |
386 |
|
2 |
26,955 |
2,247 |
519 |
|
3 |
33,874 |
2,823 |
652 |
|
4 |
40,793 |
3,400 |
785 |
|
5 |
47,712 |
3,976 |
918 |
|
6 |
54,631 |
4,553 |
1,051 |
|
7 |
61,550 |
5,130 |
1,184 |
|
8 |
68,469 |
5,709 |
1,317 |
|
For each additional
member add: |
+6,919 |
+577 |
+134 |
*One month of current pay stubs for each employed household
member
*Verification of unemployment (check stub)
*Verification of disability (Disability award letter/ check)
*Verification of Compensation (Compensation letter /check)
*Letter from court regarding child support/alimony
*Social Security Income award letter/ check
*Self-employed income records (bring last year’s income tax
form or quarterly estimated report)
*Verification of lump sum reimbursements (award letter)
*Proof of any other income into your household (rental
income, income from estates/trusts, interest/dividends, etc.
*Any other cash received or withdrawn from any source (bank
statements or bank book)
Nutrition Education 
Provide Food Package Coupons 
Work Cooperatively with Physicians and Other
Agencies 
