[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-303155-105":53,"doc-detail-303155-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","school-fee-waiver-2006-2007-application-for-waiver-of-confidentiality","School Fee Waiver - 2006-2007 Application for Waiver of Confidentiality","","School Fee Waiver materials for the 2006-2007 period explain how an adult completes a consent and information-sharing section related to the hawk-i/Medicaid Information Form. The document clarifies that releasing free and reduced price meal eligibility data can support determining eligibility for school fee waivers and related benefits, including textbooks and other class fees. It specifies what information is shared, how it may be used, the one-year authorization window, and how families can revoke consent in writing.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/school-fee-waiver-2006-2007-application-for-waiver-of-confidentiality/303155/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/school-fee-waiver-2006-2007-application-for-waiver-of-confidentiality/303155.png","ImageObject",442,249,{"name":88,"@type":89},"Mia  ","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-24","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":79},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What does the adult consent on the hawk-i/Medicaid Information Form allow?","Question",{"text":108,"@type":109},"It allows school/home sponsor/child care/Head Start officials to share free and reduced price meal eligibility information with hawk-i or Medicaid so children can be identified for potential free or low-cost health insurance. The program may only use the information for eligibility identification and contact.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"Is the adult required to allow information sharing with hawk-i or Medicaid?",{"text":113,"@type":109},"No. Choosing not to share the information does not affect eligibility for free or reduced price meals.",{"name":115,"@type":106,"acceptedAnswer":116},"How does the Self-Employment Income Worksheet determine reportable income?",{"text":117,"@type":109},"It guides calculations using the most recent U.S. Individual Income Tax Return (Form 1040), separating farming income, proprietorship income, and income from other sources. It also notes that personal and non-business deductions are not allowed to reduce gross business income for this purpose.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},303155,1790180521,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":79,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":9},687207024478,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Name of adult completing form   \nhawk-i /Medicaid Information Form  \nRead this information and sign if you decide you do not want your name released to hawk-i or Medicaid.  \nIf your children do not have health insurance, you will be interested to know that many families getting free and reduced price meals can also get free or low-cost health insurance for their children.  \nThe law now allows us to share your free and reduced price meal eligibility information with Medicaid and hawk-i, the State’s medical insurance program for children. Specifically , we will give them your child’s name and your name and address. Medicaid and hawk-i can only use the information to identify children who may be eligible for free or low-cost health insurance and then to contact you. They are not allowed to use the information from your free and reduced meal application for any other purpose.  \nYou are not required to allow us to share information from your children’s free and reduced price meal application with Medicaid orthe hawk-i program. It will not affect your children’s eligibility for free and reduced price meals. If you do NOT want your information shared with Medicaid or hawk-i, you must tell us by completing the information below at the time you complete your free/reduced application. If you want further information, you may call hawk-i at 1-800-257-8563.  \nI DO NOT want school/home sponsor/child care or Head Start center officials to share information from my free and reduced price meal application with Medicaid or hawk-i. Also, if you are already receiving Medicaid or hawk-i, please sign below. This will avoid another contact.  \nChild’s Name:   School/Child Care/Head Start Center:  Child’s Name:   School/Child Care/Head Start Center:  Child’s Name:   School/Child Care/Head Start Center:  Parent/Guardian Name ( Printed)  Signature  Date   \nSCHOOL FEE WAIVER  \n2006-2007 Application for Waiver of Confidentiality  \nDear Parent or Guardian,  \nIf your child(ren) qualify for free or reduced price meals, you may also be eligible for other benefits. Oneof the benefits is free or reduced textbook and other class fees. Complete this form and return with your application for free/reduced price meals.  \n SCHOOL FEE WAIVER: YES. I wish to apply for a waiver of payment of textbook and other school fees for my student(s) . School personnel may release my student(s) free and reduced-price meal eligibility status to determine eligibility for school fee waivers. (This does not include ativity pass fees)  \nI understand that I will be releasing information that will show that I applied for free and reduced-price school meals for my child(ren) . I give up my rights to confidentiality for textbook and other school fees. This authorization is in effect for one year. I understand that I may revoke this release in writing at any time.  \nI certify that I am the parent/guardian ofthe child(ren) for whom application is being made.  \nPrinted Name of Parent/Guardian  \nSignature of Parent/Guardian  \nDate Signed  \nSelf-Employment Income Worksheet  \nThis worksheet will assist you in calculating the amount to report if you engage in farming, a proprietorship or have income from other sources.  \nPersons engaged in farming or who operate other types of private businesses where cash flow varies throughout the year, making it impossible to predict monthly income with any accuracy, may use their income tax records from the preceding calendar year as a basis for applying for the free and reduced price meals. The income to be reported is income derived from the business venture less operating costs incurred in the generation of that income. Deductions for personal expenses such as medical expenses and other non-business deductions are not allowed in reducing gross business income.  \nIf you have additional income from other kinds of employment , this income must be treated as separate and apart from the income generated from your business venture. USDA DOES NOT recognize incom","cbCaisHdn0TltFUa","https://ap.wps.com/l/cbCaisHdn0TltFUa","pdf",122325,"English","# Adult Consent and Information Sharing\n## Purpose of Consent\n## Use Restrictions and Contact Notice\n# School Fee Waiver Application\n## Eligibility and Requested Waiver\n## Confidentiality and Authorization Term\n# Self-Employment Income Worksheet\n## How to Calculate Allowable Income\n## Farming, Proprietorship, and Other Sources","[{\"question\":\"What does the adult consent on the hawk-i/Medicaid Information Form allow?\",\"answer\":\"It allows school/home sponsor/child care/Head Start officials to share free and reduced price meal eligibility information with hawk-i or Medicaid so children can be identified for potential free or low-cost health insurance. The program may only use the information for eligibility identification and contact.\"},{\"question\":\"Is the adult required to allow information sharing with hawk-i or Medicaid?\",\"answer\":\"No. Choosing not to share the information does not affect eligibility for free or reduced price meals.\"},{\"question\":\"How does the Self-Employment Income Worksheet determine reportable income?\",\"answer\":\"It guides calculations using the most recent U.S. Individual Income Tax Return (Form 1040), separating farming income, proprietorship income, and income from other sources. It also notes that personal and non-business deductions are not allowed to reduce gross business income for this purpose.\"}]","School Fee Waiver - 2006-2007 Application for Waiver of Confidentiality | PDF",1789800127]