Documents/Forms

Verification Forms

• Letter of Verification Results and Adverse Action for Income Households
  • Version 1: LEAs Not Receiving School Meals Assistance Revenue for Transition (SMART) Funds for School Year 2022-23
    • English: Letter of Verification Results and Adverse Action for Income Households  August 2022
    • Spanish: Ejemplo de carta de resultados de verificación y medida adversa para grupos familiares con ingresos  August 2022
  • Version 2: LEAs Receiving SMART Funds for School Year 2022-23
    • English: Letter of Verification Results and Adverse Action for Income Households  August 2022
    • Spanish: Ejemplo de carta de resultados de verificación y medida adversa para grupos familiares con ingresos  August 2022
• Household Letter to Verify Eligibility
  • English: Household Letter to Verify Eligibility (English)  August 2022
  • Spanish: Household Letter to Verify Eligibility: Ejemplo de carta para el grupo familiar a fin de verificar la elegibilidad de la familia  August 2022
• Household Letter: Second Notification to Verify Eligibility
  • English:Household Letter: Second Notification to Verify Eligibility  August 2022
  • Spanish: Household Letter: Second Notification to Verify Eligibility: Ejemplo de carta para el hogar de segundo aviso para verificar la elegibilidad familiar  August 2022
• Household Employer Letter
  • English: Household Employer Letter   August 2022
  • Spanish: Household Employer Letter: Ejemplo de carta de empleador de grupo familiar  August 2022
• Household Letter for Social Security Office
  • English: Household Letter for Social Security Office  August 2022
  • Spanish: Household Letter for Social Security Office: Ejemplo de carta para grupo familiar de la Oficina del Seguro Social  August 2022
• Optional Household Letter: Notification of Continuation of Benefits as a Result of Verification 
  • English: Optional Household Letter: Notification of Continuation of Benefits as a Result of Verification  August 2022
  • Spanish: Optional Household Letter: Notification of Continuation of Benefits as a Result of Verification: Ejemplo de carta opcional para el grupo familiar: Notificación de continuación de beneficios como consecuencia de la verificación  August 2022
• Verification Selection Worksheet  August 2022
• Verification Collection Report
  This report is completed in the Online Application and Claiming System for Connecticut Child Nutrition Programs
• Completing the Verification Collection Report

Foreign Language Forms

USDA Foreign Language Free and Reduced-price Application and Verification forms
After selecting the desired language and document type (Word or PDF), the verification forms are located at the end of the document.