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A Local Education Agency (LEA) documents the extension when any household member receives qualifying benefits, following USDA rules for categorically eligible households. The form collects household member details, case identifiers, documentation date, and school attendance, and lists each eligible child. Supporting documentation must be kept for three years plus the current year, along with a signed determining official and required civil rights and complaint notices.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/extending-snaptanfincome-eligible-medicaid-eligibility-for-free-or-reduced-price-mealmilk-benefits-direct-certification-report/535838/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/extending-snaptanfincome-eligible-medicaid-eligibility-for-free-or-reduced-price-mealmilk-benefits-direct-certification-report/535838.png","ImageObject",300,407,{"name":92,"@type":93},"Rizky","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-10","2026-10-10",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",15,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What triggers extending free or reduced-price meal/milk benefits to all children in a household?","Question",{"text":113,"@type":114},"Receipt of SNAP/TANF/Income Eligible Medicaid benefits by any household member provides free or reduced-price meal/milk benefits to all children in the household under USDA rules for categorically eligible benefits.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What information does the LEA need to include on the documentation form?",{"text":118,"@type":114},"The form requests the household member receiving benefits, SNAP/TANF/Medicaid case identification (if known), date of documentation, school attending, and a list of the eligible children with their names and school attendance.",{"name":120,"@type":111,"acceptedAnswer":121},"How long must the supporting documentation be maintained?",{"text":122,"@type":114},"The documentation must be maintained to support the claim for reimbursement for three years plus the current year.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},535838,1791689364,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":81,"preview_page_count":4},962085564807,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Use your \"Mouse\" or \"Tab\" key to move through the fields and check boxes. After completing last field, save document to hard drive to make future updates or click Print button.   \nExtending SNAP/TANF/Income Eligible Medicaid Eligibility (Categorical Eligibility) to ALL Children in a Household to Receive Free or Reduced-Price Meal/Milk Benefits  \nThis form should be used by a Local Education Agency (LEA) to document the extension of free or reduced-price meal/milk benefits to all children in the same household due to the receipt of SNAP/TANF/Income Eligible Medicaid benefits within the household.  \nReceipt of SNAP/TANF/Income Eligible Medicaid benefits by any household member (adult or child) provides free or reduced-price meal/milk benefits to all children within the household under rules by the USDA for categorically eligible benefits. The LEA, to the extent possible, must extend eligibility for free or reduced-price meals to all children in what would be considered a household for the purposes of applying for free or reduced-price meals or free milk.  \nPlease include all of the information identified below. Such documentation must be maintained to support the Claim for Reimbursement and must be maintained for three years plus the current year.  \nName of Household Member Receiving SNAP/TANF/Income Eligible Medicaid Benefits:   SNAP/TANF/Medicaid Case Identification Number (if known):   Date of Documentation:   School Attending:    \n\n| Type of Documentation: 􀀀 Direct Certification Report\u003Cbr>􀀀 Household Contact |  | 􀀀 Enrollment Records of the School Eligibility: 􀀀 Free 􀀀 Reduced-Price\u003Cbr>􀀀 Other (Please identify)   |  |\n| --- | --- | --- | --- |\n| The child(ren) listed below is/are member of the household and free or reduced-price meal or milk benefits will be extended to them. |  |  |  |\n| Name of Child |  |  | School Attending |\n| 1. |  |  |  |\n| 2. |  |  |  |\n| 3. |  |  |  |\n| 4. |  |  |  |\n| 5. |  |  |  |\n| 6. |  |  |  |\n| 7. |  |  |  |\n| 8. |  |  |  |\n| 9. |  |  |  |\n| 10. |  |  |  |\n|  |  |  |  |\n| Signature of Determining Official Date\u003Cbr>In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.\u003Cbr>Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g. , Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.\u003Cbr>To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: [https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf](https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866))[, from any USDA office, by calling (866)](https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866))[ ](https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866))[632-9992](632-9992) , or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and da","cbCaiizqS0iUZFLB","https://ap.wps.com/l/cbCaiizqS0iUZFLB","pdf",341003,"English","# Extending categorical eligibility for meal/milk benefits\n## Required documentation and household information\n## Child eligibility listing and school enrollment\n## Signature, record retention, and civil rights notice\n## How to file a discrimination complaint","[{\"question\":\"What triggers extending free or reduced-price meal/milk benefits to all children in a household?\",\"answer\":\"Receipt of SNAP/TANF/Income Eligible Medicaid benefits by any household member provides free or reduced-price meal/milk benefits to all children in the household under USDA rules for categorically eligible benefits.\"},{\"question\":\"What information does the LEA need to include on the documentation form?\",\"answer\":\"The form requests the household member receiving benefits, SNAP/TANF/Medicaid case identification (if known), date of documentation, school attending, and a list of the eligible children with their names and school attendance.\"},{\"question\":\"How long must the supporting documentation be maintained?\",\"answer\":\"The documentation must be maintained to support the claim for reimbursement for three years plus the current year.\"}]","Extending SNAP/TANF/Income Eligible Medicaid Eligibility for Free or Reduced-Price Meal/Milk Benefits - Direct Certification Report | PDF",1791601213]