Documents/Forms

Verification Forms

• Letter of Verification Results and Adverse Action for Income Households (English)   September 2021
• Letter of Verification Results and Adverse Action for Income Households (Spanish)  September 2021
  • Ejemplo de carta de resultados de verificación y medida adversa para grupos familiares con ingresos
• Household Letter to Verify Eligibility (English)  September 2021
• Household Letter to Verify Eligibility (Spanish)  September 2021
  • Ejemplo de carta para el grupo familiar a fin de verificar la elegibilidad de la familia
• Household Letter: Second Notification to Verify Eligibility (English)  September 2021
• Household Letter: Second Notification to Verify Eligibility (Spanish)  September 2021
  • Ejemplo de carta para el hogar de segundo aviso para verificar la elegibilidad familiar
• Household Employer Letter (English)   August 2021
• Household Employer Letter (Spanish)  August 2021
  • Ejemplo de carta de empleador de grupo familiar
• Household Letter for Social Security Office (English)  August 2021
• Household Letter for Social Security Office (Spanish)  August 2021
  • Ejemplo de carta para grupo familiar de la Oficina del Seguro Social 
• Optional Household Letter: Notification of Continuation of Benefits as a Result of Verification (English)  August 2021
• Optional Household Letter: Notification of Continuation of Benefits as a Result of Verification (Spanish)  August 2021
  • Ejemplo de carta opcional para el grupo familiar: Notificación de continuación de beneficios como consecuencia de la verificación
• Verification Selection Worksheet
• 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.