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It informs the parent or guardian that students listed are automatically approved based on eligibility status tied to SNAP, TANF, income-eligible Medicaid, or foster child circumstances. It instructs recipients not to submit a household eligibility application for listed students, explains how benefits continue unless the family opts out, provides an option to decline benefits, and directs contact procedures if information is incorrect or household students are not listed. The letter includes civil rights and non-discrimination notices and USDA complaint filing instructions.",{"@graph":69,"@context":122},[70,84,105],{"@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/sample-notification-letter-direct-certification/535878/",{"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/sample-notification-letter-direct-certification/535878.png","ImageObject",300,407,{"name":92,"@type":93},"Chumphorn","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-10","2026-10-10",true,{"@type":102,"interactionType":103,"userInteractionCount":56},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Who is automatically approved for free school meals under this direct certification notice?","Question",{"text":112,"@type":113},"Each student listed below is automatically approved for free school meals for the current school year based on the parent/guardian eligibility status (SNAP, TANF, income-eligible Medicaid, or foster child status).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Do parents need to submit a Household Eligibility Application for the listed students?",{"text":117,"@type":113},"No. Please do not fill out a Household Eligibility Application for free or reduced price meals for the students listed above.",{"name":119,"@type":110,"acceptedAnswer":120},"How can a family opt out of free meal benefits for their child(ren)?",{"text":121,"@type":113},"To opt out, the parent or guardian must completely fill out the information in the box below and return it to the school office no later than the insert date, and provide the required date and signature.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},535878,1791688776,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":56,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81,"preview_page_count":4},2336475401981,"https://ap-avatar.wpscdn.com/avatar/22000c94efd8d5204d?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786935347598174694","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.   \nSAMPLE NOTIFICATION LETTER-DIRECT CERTIFICATION  \nDate:    \nDear Parent/Guardian:  \nEach student identified below is automatically approved for free school meals for the current school year based on your eligibility for Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance to Needy Families (TANF), Income Eligible Medicaid or Foster Child status.  \n\n| Name of Student | Grade | Assistance Source | School Name |\n| --- | --- | --- | --- |\n|  |  |  |  |\n|  |  |  |  |\n|  |  |  |  |\n|  |  |  |  |\n|  |  |  |  |\n|  |  |  |  |\n\nPlease do not fill out a Household Eligibility Application for free or reduced price meals for the students listed above. This student(s) will receive free meals unless you notify us that you do not want to receive these benefits. If you do not want your child to receive free meal benefits please completely fill out the information in the box below and return to the school office no later than   (Insert Date)  \nIf you have student(s) in your household who are not listed above, please contact this office at the telephone number provided below at your earliest convenience. A Household Eligibility Application is NOT needed; free meal benefits will be extended to all children residing in the same household except foster child status is for the foster child only.  \n􀀀 I DO NOT want my child(ren), as listed above, to receive free meal benefits.  \nDate Signature of Parent or Guardian  \nIf any of the information listed above is incorrect, or you have any questions, please contact this office at (  )    \nName Title  \nIn 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.  \nProgram 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.  \nTo 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-0508-0002-508-1](https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-1)1-28-17Fax2Mail. pdf, from any USDA office, by calling (866) 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 date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:  \n1. mail:  \nU.S. Department of Agriculture  \nOffice of the Assistant Secretary for Civil Rights  \n1400 Independence Avenue, SW  \nWashington, D.C. 20250-9410; or  \n2. fax:  \n(833) 256-1665 or (202) 690-7442; or  \n[3. email:](3. email:)  \n[program.intake@usda.gov](program.intake@usda.gov)  \nThis institution is an equal opportunity provider.  \nISBE 69-15 (6/22)  \nPrint  \nReset Form","cbCaimgJYFmdv8YP","https://ap.wps.com/l/cbCaimgJYFmdv8YP","pdf",119882,"English","# Free Meals Direct Certification Notice\n## Automatic Approval Basis\n## Parent/Guardian Actions and Opt-Out Instructions\n## Household Eligibility Application Guidance\n## Civil Rights and USDA Non-Discrimination Notice\n## How to File a Program Discrimination Complaint","[{\"question\":\"Who is automatically approved for free school meals under this direct certification notice?\",\"answer\":\"Each student listed below is automatically approved for free school meals for the current school year based on the parent/guardian eligibility status (SNAP, TANF, income-eligible Medicaid, or foster child status).\"},{\"question\":\"Do parents need to submit a Household Eligibility Application for the listed students?\",\"answer\":\"No. Please do not fill out a Household Eligibility Application for free or reduced price meals for the students listed above.\"},{\"question\":\"How can a family opt out of free meal benefits for their child(ren)?\",\"answer\":\"To opt out, the parent or guardian must completely fill out the information in the box below and return it to the school office no later than the insert date, and provide the required date and signature.\"}]","SAMPLE NOTIFICATION LETTER - DIRECT CERTIFICATION | PDF",1791601286]