Child and Adult Care Food Program (CACFP)

Meal Benefit Income Eligibility

Last Published: 08/26/2015

These links contain prototype forms with required information that must be provided to households and day care home providers:

  • Letter to Households: Child Day Care and Tier II Providers and Adult Day Care
  • Letter to Tier I and Family Day Care Home Providers
  • Meal Benefit Income Eligibility Form: Child Day Care and Adult Day Care (with Instructions)

Note: States are not required to use the attached prototypes, but must ensure that the information is provided.


Meal Benefit Income Eligibility Form - English

Meal Benefit Income Eligibility Forms in Other Languages
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