[YOUR LETTERHEAD]

STANDARD SAMPLE SIZE VERIFICATION PLAN

[NAME OF SCHOOL] will use the standard sampling to select from approved applications on file October 1st of each school year. The verification process will be completed by November 15th annually.

The applications selected will be chosen by using the following standard sample size process.

[NAME OF SCHOOL] designates [NAMEand TITLE OF VERIFICATION OFFICIAL]as the district-wide verification official. The district-wide official will provide training to individuals who perform verification on [ENTER DATE – (MUST OCCUR BEFORE OCTOBER 1st)].

[NAME OF SCHOOL] designates [NAME and TITLE CONFIRMATION REVIEWOFFICIAL] as the confirmation review official. Confirmation reviews will be conducted prior to verification procedures. All documents pertaining to the confirmation reviews will be maintained for three years plus the current year.

Documentation of the method used for determining application selection will be maintained for three years beyond the current year. Documentation will include: how each application was verified; dates notices were sent; notes on contacts made; results of verification; reasons for changes in eligibility; and signature of reviewing official.

Eligibility will be confirmed through written evidence, collateral contacts, agency records, school conferences, and other sources as appropriate.

A copy of the Selection Notification letter sent to households is attached. [ATTACH COPY OF LETTER].

Each household will be required to submit documentation supporting income at the time of application up to when the application was selected for verification. The verifying official(s) will review the income documentation to determine each household’s eligibility. If no information is supplied, or if the documentation does not support the benefits for which the household has been approved, [NAME OF SCHOOL]will reduce or terminate benefits as appropriate.

Households will be given ten calendar days notice of adverse action. A change in benefits/termination letter is attached. Households may appeal a decision made by [NAME OF SCHOOL]. If the household appeals the decision within the ten calendar days, the district will continue to provide benefits until a decision has been made regarding that appeal.

[NAME and TITLE OF HEARING OFFICIAL] will serve as the appeal hearing official. The same procedures used to appeal the free and reduced-price application will be used for verification appeals.

Households submitting Supplemental Nutrition Assistance Program (SNAP), formerly the Food Stamp program, or Temporary Assistance for Needy Families (TANF) information in lieu of income information will be verified by [choose one] (1) submitting the case numbers of the randomly selected households to the Department of Children and Families for confirmation OR (2) including these households in the notification process for submitting documentation of eligibility. A current Notice of Eligibility Determination from the Department of Children and Families must be submitted.

Procedure for Standard Selection Verification

This procedure requires that sponsors verify the eligibility of a sample of applications approved for free and reduced-price meal benefits selected from error-prone households indicating income within the following guidelines: Annual income within $1,200/year; monthly income within $100/month; twice per month income within $50; bi-weekly income within $46.15; and weekly income within $23.07/week.

The minimum number of applications to be reviewed for this group must be the lesser of 3,000 or 3 percent of the total approved applications for free and reduced-price meal benefits on file by October 1st.

ACTION STEPS / EXAMPLE / YOUR SCHOOL
Determine the total number of approved applications for free and reduced-price meal benefits on file as of October 1. / 900 / _____Total Applications
Determine the number of SNAP/TANF households and income households. / 600 SNAP/TANF
300 Income
900 Total / _____ SNAP/TANF
_____ Income
_____ Total
Determine the number of applications required to fill the 3 percent income sample size. / .03 x 900 = 27 / .03 x _____ = _____
From the error-prone income group, select the number of applications for households that report income: Annual income within $1,200/year; monthly income within $100/month; twice per month income within $50; bi-weekly income within $46.15; and weekly income within $23.08/week /
  • If there are more than 27, randomly sample 27 to verify.
  • If there are less than 27, verify those plus randomly select other households’ applications to complete the sample size.

*Remember* - Keep up with the number of children approved on each application! This information must be reported to United States Department of Agriculture by November 30 each year!

“The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or if all or part of an individual's income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities.)

If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at .

Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339; or (800) 845-6136 (in Spanish).

USDA is an equal opportunity provider and employer.”

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