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THE CHILD AND ADULT CARE FOOD PROGRAM (CA CFP) FLY 2017, Rev. 6/16 HOUSEHOLD SIZEINCOME STATEMENT (HIS) For Establishing Providers Tier 1 Status: Complete and return this form to your sponsor for

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What is household size-income statement hsis?

The household size-income statement (HSIS) is a form used to report information about the size and income of a household.

Who is required to file household size-income statement hsis?

Any individual or family receiving government assistance or benefits may be required to file a household size-income statement (HSIS).

How to fill out household size-income statement hsis?

To fill out a household size-income statement (HSIS), individuals must provide information about the number of people in their household and their total income.

What is the purpose of household size-income statement hsis?

The purpose of the household size-income statement (HSIS) is to determine eligibility for government assistance programs based on household size and income.

What information must be reported on household size-income statement hsis?

On a household size-income statement (HSIS), individuals must report details about their household composition and total income.

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