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California Department of Education Nutrition Services DivisionChild and Adult Care Food Program DCC 04 (REV. 9/2019) Page 1 of 7MEAL BENEFIT FORM FOR PARENTS (TIER II HOMES) Complete, sign, and return
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How to fill out meal benefit form for

01
Start by gathering all the necessary information and documents such as your income details, proof of address, and the names and ages of all the members in your household.
02
Read the instructions carefully on the meal benefit form to understand the eligibility criteria and required information.
03
Fill out the personal information section accurately, providing your name, contact details, and other relevant information.
04
Provide detailed information about your household members, including their names, ages, and relationships to you.
05
Enter your income details accurately, including any wages, government benefits, or other sources of income for everyone in your household.
06
Attach all necessary documents as requested, such as pay stubs or proof of enrollment in a government assistance program.
07
Double-check all the information you have provided to ensure accuracy and completeness.
08
Sign and date the form as required, and make a copy for your records.
09
Submit the completed meal benefit form to the appropriate authority or organization as instructed, either in person or by mail.
10
Follow up on the status of your application if necessary and provide any additional information or documentation if requested.

Who needs meal benefit form for?

01
The meal benefit form is typically needed by individuals or households who are seeking financial assistance or support to meet their nutritional needs.
02
This form is commonly used to determine eligibility for programs that provide free or reduced-price meals, such as the National School Lunch Program or the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
03
People who have limited income or are facing economic hardships may need to fill out this form to receive meal benefits for themselves and their families.
04
This could include low-income families, individuals receiving government assistance, students, elderly individuals, or pregnant women.
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Meal benefit form is used to determine eligibility for free or reduced-price meals for students in schools.
Parents or guardians of students who wish to apply for free or reduced-price meals at school are required to file the meal benefit form.
Parents or guardians can obtain the meal benefit form from their child's school and fill it out completely with accurate information about their household income and size.
The purpose of the meal benefit form is to ensure that students from low-income families have access to nutritious meals at school.
The meal benefit form requires information such as household size, income, and any assistance programs the family participates in.
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