State CN Agency

APPENDIX C18. STATE MEAL CLAIM REQUST

OMB Number: 0584-XXXX

Expiration Date: XX/XX/XXXX

<DATE>

<STATE DIRECTOR NAME>, <TITLE>

<OFFICE/DEPARTMENT NAME>

<STREET ADDRESS >

<CITY, STATE ZIP>

Dear < DIRECTOR NAME>:

Please know that we sincerely appreciate all of your efforts for the Erroneous Payments in Child Care Centers Study (EPICCS). Nothing we have achieved thus far would have been possible without your cooperation. EPICCS is supporting the Food and Nutrition Service’s compliance with the Improper Payments Elimination and Recovery Improvement Act (IPERIA) of 2012. These efforts will also work to improve the Child and Adult Care Food Program’s (CACFP’s) efficiency, integrity, and continuity while protecting the limited resources available to the program.

We are contacting you now to request the final meal claims for <INSERT SPONSOR(S)> for <INSERT MONTH, YEAR>, including the number of meals claimed for at the free, reduced priced, and paid.

We kindly request that you submit the requested administrative data files by <DUE DATE>. Electronic Excel or CSV formatted text files can be sent via email to [email protected]. Hardcopy reports containing these data can be sent to our secured fax line at 1-844-224-2889.

This request complies with the Healthy, Hunger-Free Kids Act of 2010 regulations. Please know the information you provide will be used for research purposes only and kept private to the extent provided by law.

If you have any questions or concerns, please do not hesitate to contact us at the toll-free number 1-855-272-0058 or at [email protected]. I thank you in advance for your help and cooperation with this final EPICCS request.

Sincerely,

<ELECTRONIC SIGNATURE>

Roline Milfort, Ph.D., PMP

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXXX. The time required for the State Child Nutrition Agency data manager to complete this information collection is estimated to average four hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the collection of information.

EPICCS Project Director