Household - 7 CFR 245

Attachment J29. Prototype Household Application for Free and Reduced Price School Meals (Kru)
This information is being collected from School food authorities and schools. This is a revision of a currently approved
information collection. The Richard B. Russell National School Lunch Act (NSLA) 42 U.S.C. § 1758, as amended, authorizes
the National School Lunch Program (NSLP). This information is required to administer and operate this program in
accordance with the NSLA. Under the Privacy Act of 1974, any personally identifying information obtained will be kept
private to the extent of the law. 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 0584-0026. The time required to complete this information
collection is estimated to average 6 minutes per response. The burden consists of the time it takes for households to
complete their application. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition
Services, Office of Policy Support, 1320 Braddock Place, Alexandria, VA 22314, ATTN: PRA (0584-0026). Do not return the
completed form to this address.





••



OMB #0584-0026 Expiration Date: XX/XX/20XX

•••



MI


•



not related.”





,


or


H

•
for
more information.






 > 


•

•






•






•

  •
  

$









•••
•••••••

•
 


 • 














•


 •
 



• 




 • 

 •
 

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$







 




 > 








•


“•
Definition of Household

Member:
“Anyone who is

living
with you and shares

income
” and expenses, even if



• X
•

X

X

X

 •
 




X



•••••••••


••































•


 •










•



•







•





•
















•














•



•
•









•






•










•

•




•

••



••
••






••

••


•

••

••







•





•





14



















••



Annual Income Conversion: Weekly x 52, Every 2 Weeks x 26, Twice a Month x 24 Monthly x 12

Eligibility:

How often?

Total Income

Weekly

Bi-Weekly

2x Month

Monthly

Household size

Free

Reduced

Denied

Categorical Eligibility
Date

Date

Date