CACFP Income Eligibility Guidance for Child Care Centers

Parts 1, 2, and 4 of the IEF are required to be completed, except if SNAP or TANF benefits are documented, then only Parts 1 and 4 are required.

Part 1: Children Enrolled at the Child Care Center

• List all children (first and last name) enrolled in the child care center.
• If you are applying for a foster child, the foster child is eligible for free meals, provided that third-party documentation is provided to the center. Mark an X in the space provided if a foster child is listed in Part 1.
• List each enrolled child’s complete date of birth (month/day/year).
• If your child receives Supplemental Nutrition Assistance Program (SNAP) benefits or Temporary Assistance for Needy Families (TANF) payments, please indicate the appropriate case number in the spaces provided and sign the form. Do not use the number on your card. You do not need to complete Part 2.
• If you have a SNAP or TANF case number for at least one of your children enrolled at the center, the eligibility extends to all of your children enrolled at the center. Skip Part 2.

Part 2: Household and Income Information

• Report income by payment cycle (i.e., weekly, monthly, etc.) for each household member.
• List other household members not included in Part 1.  A household is a group of related or unrelated individuals who live as one economic unit (i.e., share living expenses). Note:  A foster child may be added to increase household size, if applicable.
• Report gross wages in the space provided. This includes all income before taxes and before other deductions.
• Income exclusions not to be reported or counted include:
  • Payments received for the care of foster children.
  • Student financial assistance provided for the costs of attendance at an educational institution, such as grants and scholarships.
  • Bank or student loans, since these funds are only temporarily available and must be repaid.
• Report welfare, child support, alimony, pensions, retirement, social security, and other income in the space provided, if applicable.

Part 3: Racial Ethnic Information – Completion Is Voluntary

Part 4: Signature

• Sign the form.
• For the IEF to be valid, you must provide the last four digits of your social security number, unless your child(ren) is a SNAP or TANF recipient. If you do not have a Social Security number, write “none” in the space provided.
• Date the form.
• Print your full name.
• Print your complete mailing address.
• Provide your phone number.

Note: The adult household member completing the IEF must attest to the fact that the information provided is correct, that it is being given in connection with the receipt of federal funds, that institution officials may verify information, and that deliberate misrepresentation may subject the individual to prosecution under applicable state and federal laws.