Get the free SFMNP Proxy Form - California Department of Food and ...

PROXY FORM 1.2.10. (Rev. 03.2020) State of California Department of Food and Agriculture Office of Grants Administration___ SF MNP PROXY FORM SF MNP participants are authorized to designate an individual

How to fill out sfmnp proxy form

How to fill out sfmnp proxy form

1. To fill out the SFMNP proxy form, follow these steps:
2. Start by downloading the SFMNP proxy form from the official website or obtain it from the local SFMNP office.
3. Fill in the personal details section, which includes the proxy participant's name, address, telephone number, and date of birth.
4. Provide information about the authorized proxy, including their name, address, telephone number, and relationship to the participant.
5. Indicate the start and end date of the proxy authorization period.
6. Sign and date the form to acknowledge that the information provided is accurate.
7. Submit the completed form to the SFMNP office or the designated authority for further processing.
8. Ensure that all the required fields are filled correctly and legibly to avoid any delays or complications in the application process.

Who needs sfmnp proxy form?

1. Individuals who are eligible for the Senior Farmers' Market Nutrition Program (SFMNP) but are unable to personally visit the farmers' market or designated SFMNP site can make use of the SFMNP proxy form.
2. The proxy form allows another person, known as the authorized proxy, to act on behalf of the eligible participant. This form is particularly useful for elderly or disabled individuals who face mobility or transportation challenges.
3. By appointing an authorized proxy, eligible individuals can still benefit from the SFMNP and have access to fresh, nutritious, and locally grown fruits, vegetables, and herbs from approved farmers' markets or roadside stands.

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What is sfmnp proxy form?

The SFMNP proxy form is a document used to designate an authorized representative to pick up farmers market nutrition program benefits on behalf of an eligible participant.

Who is required to file sfmnp proxy form?

Participants who are unable to pick up their farmers market nutrition program benefits in person are required to file the SFMNP proxy form to designate someone to do so on their behalf.

How to fill out sfmnp proxy form?

The SFMNP proxy form can be filled out by providing the participant's information, the authorized representative's information, and signing and dating the form.

What is the purpose of sfmnp proxy form?

The purpose of the SFMNP proxy form is to ensure that eligible participants can still receive their farmers market nutrition program benefits even if they are unable to pick them up in person.

What information must be reported on sfmnp proxy form?

The SFMNP proxy form must include the participant's name, address, phone number, signature, as well as the authorized representative's name, address, phone number, and signature.