Excel Sheet Download 11634 | Verificationsummaryreportfns 742

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Sheet 1: Reporting Template

Verification Summary Report (FNS-742)
School Year 2018-19

E-mail completed Excel form as an attachment to:
nslpreports@k12.wa.us
Subject Line must include LEA Name

LEA Information

Name:

ID Number (from WINS):

City:

Zip Code:

Type of LEA: (select one)

Public

Private/Non-Profit

SECTION 1 - Total Schools, Residential Child Care Institutions, and Enrolled Students (All LEAs must report Section 1)

Report all data as of the last operating day in October 2018

Number of Schools/
Institutions

Number of Enrolled Students

1-1.
Total number of schools and total number of enrolled students
A.

1-2.
Total RCCIs
A.

1-2a.
RCCIs with day students (report ONLY day students)
A.

1-2b.
RCCIs without day students
A.

SECTION 2 - Community Eligibility Provision and/or Provision 2 (Only report Section 2 for LEAs with schools operating CEP and/or Provision 2)

Report all data as of the last operating day in October 2018

Number of Schools/
Institutions

Number of Students

2-1.
Operating the Community Eligibility Provision (CEP)
A.

2-2.
Operating Provision 2 in a BASE year for NSLP and SBP
A.

2-3.
Operating Provision 2 in a NON-BASE year for NSLP and SBP
A.

2-2a.
Provision 2 students reported as FREE in a NON-BASE year
B.

2-2b.
Provision 2 students reported as REDUCED-PRICE in a NON-BASE year
B.

2-4.
Operating Provision 2 for only the School Breakfast Program
A.

SECTION 3 - Students approved as FREE Eligible and NOT subject to verification (All LEAs must report Section 3 - If not applicable, check box 3-1)

Report all data as of the last operating day in October 2018 - Do NOT include students enrolled in CEP and/or Provision 2 schools

3-1.

ALL schools and/or RCCIs in the LEA were not required to perform Direct Certification with Basic Food

(i.e., NON-BASE year Provision 2 or CEP for all schools)

Number of FREE Students

3-2.
Students directly certified through Basic Food
B.

3-3.
Students directly certified Free through Medicaid
B.

3-4.
Students directly certified Reduced through Medicaid
B.

3-5.
Students directly certified through other programs
B.

(TANF, FDPIR; Homeless, Migrant, Runaway, or Foster; Headstart, Pre-K Even Start; or non-applicant, but approved by local officials.) DO NOT include students already counted in 3-2, 3-3, and 3-4.

SECTION 4 - Students approved as FREE or REDUCED-PRICE eligible through application (All LEAs collecting applications must report Section 4)

Number of Applications
(As of
October 1, 2018)

Number of Students
(As of the last operating day in October 2018)

4-1.
Approved as categorically FREE eligible
A.

(Based on those providing documentation, e.g., case number for Basic Food, TANF, FDPIR on an application)

4-2.
Approved as FREE eligible
A.

(Based on household size and income information)

4-3.
Approved as REDUCED-PRICE eligible
A.

(Based on household size and income information)

4-4.
Total number of approved free or reduced applications on file as of October 1, 2018
0

SECTION 5 - Verification Details (All LEAs must report Section 5 - If exempt, check box 5-1)

5-1.

ALL schools and/or RCCIs are exempt from Verification (See instructions for list of exemptions. If exempt, no further reporting is required.)

5-2.
Was verification performed and completed? (Select one)

Yes, completed by November 15, 2018

Yes, completed after November 15, 2018 (If completed after November 15, 2018, a Corrective Action Plan is required - see instructions.)

No, verification was NOT performed or the process was not completed

5-3.
Type of verification process used (Select one)
Number of applications to verify

3% Focused
0

3% Random
0

1% Plus 1/2% Focused
0

Number of Applications
(Number on file as of October 1, 2018)

5-4.
Total ERROR PRONE applications (If 3% Random was used, enter N/A)
A.

5-5.
Number of applications selected for verification sample
A.

5-6.

Direct Verification was not conducted in the LEA

(i.e., NO schools and/or RCCIs in the LEA performed direct verification)

Number of Applications

Number of Students

5-7.
Number confirmed through Direct Verification
A.

Do NOT report these results in Section 6.

5-8.
Total questionable applications verified for cause
A.

(As of November 15, 2018)

(The number of applications verified for cause, in addition to the verification requirement.)

(If Verification for Cause was not done, enter N/A)

SECTION 6 - Results of Verification by Original Benefit Type

Enter the Application ID for each application where the original benefit type is FREE - Categorically Eligible. Do NOT use actual household name. Assign an ID.

For each Application ID, enter a "1" in the appropriate column to represent the results of the first verification review. Select only one category for each application.

Enter the number of students included on the approved application.

Use red font for applications verified for cause. Do NOT report the results of applications that were Directly Verified in this section!

6-1.
Original Approval - FREE-Categorically Eligible (Certified as FREE based on Basic Food/TANF/FDPIR Documentation (e.g. case number) on application)

FREE -
Categorically Eligible
Results of First Verification Review of Original Benefit Type

Application ID

Responded,
NO CHANGE
Number of Students

Responded, Changed to REDUCED-PRICE
Number of Students

Responded, Changed to PAID
Number of Students

NO RESPONSE, Changed to PAID
Number of Students

Example
1234

1
3

0
0

SECTION 6 - Results of Verification by Original Benefit Type (cont.)

Enter the Application ID for each application where the original benefit type is FREE - Income. Do NOT use actual household name. Assign an ID.

For each Application ID, enter a "1" in the appropriate column to represent the results of the first verification review. Select only one category for each application.

Enter the number of students included on the approved application.

Use red font for applications verified for cause. Do NOT report the results of applications that were Directly Verified in this section!

6-2.
Original Approval - FREE-Income (Certified as FREE based on income/household size on application)

FREE -
Income

Results of First Verification Review of Original Benefit Type

Application ID

Responded,
NO CHANGE
Number of Students

Responded, Changed to REDUCED-PRICE
Number of Students

Responded, Changed to PAID
Number of Students

NO RESPONSE, Changed to PAID
Number of Students

Example
4567

1
2

0
0

SECTION 6 - Results of Verification by Original Benefit Type (cont.)

Enter the Application ID for each application where the original benefit type is REDUCED-PRICE - Income. Do NOT use actual household name. Assign an ID.

For each Application ID, enter a "1" in the appropriate column to represent the results of the first verification review. Select only one category for each application.

Enter the number of students included on the approved application.

Use red font for applications verified for cause. Do NOT report the results of applications that were Directly Verified in this section!

6-3.
Original Approval - REDUCED PRICE-Income (Certified as REDUCED-PRICE based on income/household size on application)

REDUCED-PRICE - Income

Results of First Verification Review of Original Benefit Type

Application ID

Responded,
NO CHANGE
Number of Students

Responded, Changed to FREE
Number of Students

Responded, Changed to PAID
Number of Students

NO RESPONSE, Changed to PAID
Number of Students

Example
8910

1
1

0
0

SECTION 7 - Verification Totals Summary

7-1.
Total number of applications verified
0

7-2.
Total number of students verified
0

7-3.
Total number of applications that did not respond
0

7-4.
Percent of applicants that did not repond
#DIV/0!

Corrective Action Plan

If verification was not completed by November 15, 2018, or the correct number of applications was not verified, a detailed Corrective Action Plan must be submitted.

The corrective action plan must provide the steps to be taken to ensure the problem will not occur in future years.

Name of Person Completing the Corrective Action Plan

Corrective Action Plan

OSPI USE ONLY

Corrective Action Plan Approved

Date

Specialist Initials

Sheet 2: Instructions

Verification Summary Report (FNS-742)

Instructions

For guidance on verification requirements and procedures, refer to the Eligibility Manual:

Eligibility Manual for School Meals

E-mail the template (as an attachment) to:
nslpreports@k12.wa.us

Subject Line must include LEA Name

The template must be submitted as an Excel document.

We cannot accept pdf or scanned copies.

LEA Information

Enter the LEA name, LEA ID Number in WINS, LEA city, LEA zip code for each LEA with schools and/or RCCI's operating the NSLP and/or SBP

Select if the LEA overall is a public or a private/non-profit entity.

SECTION 1 – Total Schools, Residential Child Care Institutions, and Enrolled Students

ALL LEAs with schools or RCCIs operating the NSLP and/or SBP must complete this section regardless if all schools are exempt from verification. If a school/RCCI operates both the NSLP and SBP, only count it once.

1-1.
(A.) Report total number of schools operating the NSLP and/or SBP and (B.) total number of students enrolled and with access to the NSLP and/or SBP as of the last operating day in October.

1-2.
(A.) Report total number of RCCIs operating the NSLP and/or SBP and (B.) total number of students enrolled and with access to the NSLP and/or SBP as of the last operating day in October.

1-2a.
(A.) Of the RCCIs reported in 1-2A, enter the number of RCCIs with day students and (B.) only the number of day students with access to the NSLP and/or SBP in these RCCIs. (Day students are those students NOT institutionalized and eligibility is determined individually by application or direct certification as applicable.)

1-2b.
(A.) Of the RCCIs reported in 1-2A, enter the number of RCCIs without day students and (B.) the number of students with access to the NSLP and/or SBP in these RCCIs.

NOTE: The sum of the RCCI students reported in 1-2a and 1-2b should equal the total in 1-2 above.

SECTION 2 – Community Eligibility Provision and/or Provision 2

Complete this section only if your LEA operates Community Eligibility Provision (CEP) or Provision 2 in some or all schools.

Report students enrolled and with access to the NSLP and/or SBP as of the last operating day in October.

2-1.
(A.) Enter the number of schools operating the Community Eligibility Provision and (B.) the number of enrolled students in these schools with access to the NSLP and/or SBP.

Special Note for Provision 2: 2-2 through 2-3 should only be reported if the school operates Provision 2 for both the SBP and NSLP resulting in no collection of F/R meal applications for the school. Schools operating Provision 2 for only the SBP and collecting F/R meal applications for the NSLP should report applicable data in 2-4.

2-2.
(A.) Enter the number of schools operating Provision 2 in a BASE year for the NSLP and SBP and (B.) the number of students enrolled in these schools. BASE year is when F/R meal applications are collected and eligibility is determined.

2-3.
(A.) Enter the number of schools operating Provision 2 in a NON-BASE year for the NSLP and SBP and (B.) the number of students enrolled in these schools. NON-BASE year is when no F/R meal applications are collected and eligibility is NOT determined.

2-3a.
Multiply the most recent BASE year FREE percentage by the enrollment reported in 2-3B to determine the number of Provision 2 students reported as FREE in a NON-BASE year.

2-3b.
Multiply the most recent base year REDUCED-PRICE percentage by the enrollment reported in 2-3B to determine the number of Provision 2 students reported as REDUCED-PRICE in a NON-BASE year.

2-4.
(A.) Enter the number of schools operating Provision 2 for only the SBP and (B.) the number of students enrolled and with access to meals in these schools. Include schools operating in both a BASE year and NON-BASE year.

SECTION 3 – Students approved as FREE Eligible and NOT subject to verification

All LEAs must complete this section. If all schools and/or RCCIs in the LEA were not required to perform direct certification with Basic Food, then enter an ‘X’ in box 3-1.

Direct Certification is the process by which the student is certified eligible based on documentation received directly from the applicable program (e.g., Basic Food or TANF agency). This process eliminates the need for the household to submit an application.

Report students approved FREE eligible as of the last operating day in October. Do NOT include students enrolled in CEP and/or Provision 2 schools.

3-1.
Check box 3-1 if ALL schools and/or RCCIs in the LEA were not required to perform Direct Certification with Basic Food. (i.e. NON-BASE year Provision 2 or CEP for ALL schools.)

3-2.
Enter the number of students directly certified through Basic Food. If a student is directly certified with Basic Food, as well as with another program (e.g., TANF, homeless, etc.), include the student in the Basic Food count. Also include in this count any student in the LEA determined eligible based on extended categorical eligibility from a directly certified student in the same household.

3-3.
Enter the number of students directly certified Free through Medicaid

3-4.
Enter the number of students directly certified Reduced through Medicaid

3-5.
Enter the number of students directly certified through programs other than Basic Food (TANF, FDPIR; Homeless, Migrant, Runaway, or Foster; Headstart, Pre-K Even Start; or non-applicant, but approved by local officials). Include students in the LEA deemed eligible due to extended categorical eligibility from a directly certified student receiving TANF or FDPIR in the same. DO NOT include Basic Food students already reported in 3-2, or directly certified Medicaid Free and Reduced students in 3-3 and 3-4.

SECTION 4 – Students approved as FREE or REDUCED-PRICE eligible through application

All LEAs with schools and/or RCCIs collecting individual household applications must report this section, including schools in a Provision 2 base year.

Report number of applications (A.) approved as of October 1 and report number of students (B.) as of the last operating day in October.

4-1.
(A.) Enter the number of applications on file as of October 1 and (B.) the number of students as of the last operating day in October approved as categorically FREE eligible based on documentation submitted on an application (i.e., case number for Basic Food, TANF, or FDPIR on an application). Include students in the LEA deemed eligible due to extended categorical eligibility via an eligible student in the primary household categorically FREE eligible with a case number for Basic Food, TANF or FDPIR on an application.

In circumstances such as when an application is filled out with a case number, but the associated students are later directly certified, you may have more applications with case numbers than students. This is okay.

4-2.
(A.) Enter the number of applications on file as of October 1 and (B.) the number of students as of the last operating day in October approved FREE eligible based on income/household size information submitted on an application.

4-3.
(A.) Enter the number of applications on file as of October 1 and (B.) the number of students as of the last operating day in October approved REDUCED-PRICE eligible based on income/household size information submitted on an application.

4-4.
Total number of free or reduced-price applications on file as of October 1. This field is automatically calculated – no entry needed.

SECTION 5 – Verification Details

5-1.
Check box 5-1 if ALL schools and/or RCCIs in the LEA are exempt from verification activities. No further reporting is required in Section 5. Verification activities are NOT required for:

· Schools/RCCIs in which all children have been certified under direct certification procedures, including children documented as eligible foster

· Migrant, runaway, or homeless children

· RCCIs which do not have day students

· Schools operating the Community Eligibility Provision district-wide

· Schools participating in Provision 2 and are in a NON-BASE year district-wide

· Schools participating only in the Special Milk Program

· Schools which do not have any free or reduced price eligible students

5-2.
Indicate whether verification was performed and completed by the deadline of November 15. If verification was completed after the deadline, report the remainder of Section 5 as applicable. You must complete a Corrective Action Plan (CAP) in the space provided at the end of the report. The CAP will include information as to how you will prevent this from happening in future years.

5-3.
If verification was completed, check the type of verification process used. The total number of applications to verify will be automatically calculated.

· 3% Focused - Verify 3% or 3,000 of approved applications, whichever is less, selected from error-prone applications on file as of October 1. If there are not enough error-prone applications, LEAs must select at random additional applications to complete sample size.

· 3% Random - Verify 3% or 3,000, whichever is less, of all randomly selected approved applications on file as of October 1.

· 1% Plus ½% Focused - Verify the lesser of 1% or 1,000 approved applications on file as of October 1 selected from error-prone applications, PLUS the lesser of one-half of one percent or 500 approved applications on file as of October 1 that provided a case number in lieu of income.

5-4.
Report all applications on file as of October 1 considered error-prone. Error-prone applications are household applications approved as of October 1 indicating income within $1200 yearly; $100 monthly; $50 twice a month; $46 every two weeks; or $23 weekly of the annual limit of the applicable income eligibility guidelines.

5-5.
Enter the total number of applications initially selected for the verification process as indicated in 5-3.

5-6.
Check box 5-6 if direct verification was NOT conducted in the LEA (no schools and/or RCCIs in the LEA conducted direct verification).

5-7.
Enter the number of applications confirmed through direct verification. Only report applications and students if FREE or REDUCED-PRICE eligibility is confirmed through direct verification. Report applications and students NOT directly verified in the appropriate category in Section 6.

5-8.
If applicable in at least one school and/or RCCI, report all applications verified for cause outside of the verification process (7 CFR 245.6a) as of November 15. Applications verified for cause are NOT considered part of the required sample size. Include the results of verification for cause by original benefit type in the appropriate category in Section 6. Use red font for applications verified for cause.

For the purposes of this report, verification is complete for:

· Households whose eligibility does not change as of the date of the confirmation of eligibility by a reviewing official

· Households that do not appeal a change in eligibility as of the first operating day following the last date given for filing an appeal in response to a notice of change in eligibility

· Households that appeal a change in eligibility as of the first operating day following a decision by the hearing official

SECTION 6 – Results of Verification by Original Benefit Type

The number of applications reported in Section 6 should include both the results of verification from the verification process and the results from any applications verified for cause reported in 5-8. Use red font to report results of verification for cause. Do NOT report the results of applications that were Directly Verified in this section.

For each category, enter the application ID in the first column. You must assign an ID number to each application. Do NOT use actual household names. Place a ‘1’ in the column corresponding to the result of first verification review of the original benefit type and enter the number of students on the application.

Responded: The household provided sufficient documentation. This includes verbal or written notification that the household declines benefits.

NO Response: The household did not provide sufficient documentation or the household did not provide a response.

6-1.
Enter results of verification for applications where original approval was designated ‘Free – Categorically Eligible’. (Certified as FREE based on Basic Food/TANF/FDPIR documentation (e.g. case number) on application.)

6-2.
Enter results of verification for applications where original approval was designated ‘Free – Income’. (Certified as FREE based on income/household size on application.)

6-3.
Enter results of verification for applications where original approval was designated ‘Reduced-Price – Income’. (Certified as REDUCED-PRICE based on income/household size on application.)

SECTION 7 - Verification Totals Summary

This section is automatically calculated. No entry needed.

Corrective Action Plan

If verification was not completed by November 15, or the correct number of applications was not verified, a detailed Corrective Action Plan must be submitted. The corrective action plan must provide the steps to be taken to ensure the problem will not occur in future years.

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...Sheet reporting template verification summary report fns school year email completed excel form as an attachment tonslpreports kwaussubject line must include lea name information id number from wins city zip code type of select one public privatenonprofit section total schools residential child care institutions and enrolled students all leas data the last operating day in october schoolsinstitutions a b rccis with only without community eligibility provision andor for cep base nslp sbp nonbase reported free reducedprice breakfast program approved eligible not subject to if applicable check box do were required perform direct certification basic food ie or directly certified through medicaid reduced other programs tanf fdpir homeless migrant runaway foster headstart prek even start nonapplicant but by local officials already counted application collecting applications categorically based on those providing documentation eg case household size income file details exempt are see instruct...

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Verification Summary Report (FNS-742)
Instructions
For guidance on verification requirements and procedures, refer to the Eligibility Manual:
Eligibility Manual for School Meals
E-mail the template (as an attachment) to:		nslpreports@k12.wa.us
Subject Line must include LEA Name
The template must be submitted as an Excel document.
We cannot accept pdf or scanned copies.

LEA Information
Enter the LEA name, LEA ID Number in WINS, LEA city, LEA zip code for each LEA with schools and/or RCCI's operating the NSLP and/or SBP
Select if the LEA overall is a public or a private/non-profit entity.

SECTION 1 – Total Schools, Residential Child Care Institutions, and Enrolled Students
ALL LEAs with schools or RCCIs operating the NSLP and/or SBP must complete this section regardless if all schools are exempt from verification. If a school/RCCI operates both the NSLP and SBP, only count it once.
1-1.	(A.) Report total number of schools operating the NSLP and/or SBP and (B.) total number of students enrolled and with access to the NSLP and/or SBP as of the last operating day in October.
1-2.	(A.) Report total number of RCCIs operating the NSLP and/or SBP and (B.) total number of students enrolled and with access to the NSLP and/or SBP as of the last operating day in October.
1-2a.	(A.) Of the RCCIs reported in 1-2A, enter the number of RCCIs with day students and (B.) only the number of day students with access to the NSLP and/or SBP in these RCCIs. (Day students are those students NOT institutionalized and eligibility is determined individually by application or direct certification as applicable.)
1-2b.	(A.) Of the RCCIs reported in 1-2A, enter the number of RCCIs without day students and (B.) the number of students with access to the NSLP and/or SBP in these RCCIs.
NOTE: The sum of the RCCI students reported in 1-2a and 1-2b should equal the total in 1-2 above.

SECTION 2 – Community Eligibility Provision and/or Provision 2
*Complete this section only if your LEA operates Community Eligibility Provision (CEP) or Provision 2 in some or all schools.*
*Report students enrolled and with access to the NSLP and/or SBP as of the last operating day in October.*
2-1.	(A.) Enter the number of schools operating the Community Eligibility Provision and (B.) the number of enrolled students in these schools with access to the NSLP and/or SBP.
Special Note for Provision 2: 2-2 through 2-3 should only be reported if the school operates Provision 2 for both the SBP and NSLP resulting in no collection of F/R meal applications for the school. Schools operating Provision 2 for only the SBP and collecting F/R meal applications for the NSLP should report applicable data in 2-4.
2-2.	(A.) Enter the number of schools operating Provision 2 in a BASE year for the NSLP and SBP and (B.) the number of students enrolled in these schools. BASE year is when F/R meal applications are collected and eligibility is determined.
2-3.	(A.) Enter the number of schools operating Provision 2 in a NON-BASE year for the NSLP and SBP and (B.) the number of students enrolled in these schools. NON-BASE year is when no F/R meal applications are collected and eligibility is NOT determined.
2-3a.	Multiply the most recent BASE year FREE percentage by the enrollment reported in 2-3B to determine the number of Provision 2 students reported as FREE in a NON-BASE year.
2-3b.	Multiply the most recent base year REDUCED-PRICE percentage by the enrollment reported in 2-3B to determine the number of Provision 2 students reported as REDUCED-PRICE in a NON-BASE year.
2-4.	(A.) Enter the number of schools operating Provision 2 for only the SBP and (B.) the number of students enrolled and with access to meals in these schools. Include schools operating in both a BASE year and NON-BASE year.

SECTION 3 – Students approved as FREE Eligible and NOT subject to verification
*All LEAs must complete this section. If all schools and/or RCCIs in the LEA were not required to perform direct certification with Basic Food, then enter an ‘X’ in box 3-1.*
Direct Certification is the process by which the student is certified eligible based on documentation received directly from the applicable program (e.g., Basic Food or TANF agency). This process eliminates the need for the household to submit an application.
*Report students approved FREE eligible as of the last operating day in October. Do NOT include students enrolled in CEP and/or Provision 2 schools.*
3-1.	Check box 3-1 if ALL schools and/or RCCIs in the LEA were not required to perform Direct Certification with Basic Food. (i.e. NON-BASE year Provision 2 or CEP for ALL schools.)
3-2.	Enter the number of students directly certified through Basic Food. If a student is directly certified with Basic Food, as well as with another program (e.g., TANF, homeless, etc.), include the student in the Basic Food count. Also include in this count any student in the LEA determined eligible based on extended categorical eligibility from a directly certified student in the same household.
3-3.	Enter the number of students directly certified Free through Medicaid
3-4.	Enter the number of students directly certified Reduced through Medicaid
3-5.	Enter the number of students directly certified through programs other than Basic Food (TANF, FDPIR; Homeless, Migrant, Runaway, or Foster; Headstart, Pre-K Even Start; or non-applicant, but approved by local officials). Include students in the LEA deemed eligible due to extended categorical eligibility from a directly certified student receiving TANF or FDPIR in the same. DO NOT include Basic Food students already reported in 3-2, or directly certified Medicaid Free and Reduced students in 3-3 and 3-4.

SECTION 4 – Students approved as FREE or REDUCED-PRICE eligible through application
*All LEAs with schools and/or RCCIs collecting individual household applications must report this section, including schools in a Provision 2 base year.*
*Report number of applications (A.) approved as of October 1 and report number of students (B.) as of the last operating day in October.*
4-1.	(A.) Enter the number of applications on file as of October 1 and (B.) the number of students as of the last operating day in October approved as categorically FREE eligible based on documentation submitted on an application (i.e., case number for Basic Food, TANF, or FDPIR on an application). Include students in the LEA deemed eligible due to extended categorical eligibility via an eligible student in the primary household categorically FREE eligible with a case number for Basic Food, TANF or FDPIR on an application.
In circumstances such as when an application is filled out with a case number, but the associated students are later directly certified, you may have more applications with case numbers than students. This is okay.
4-2.	(A.) Enter the number of applications on file as of October 1 and (B.) the number of students as of the last operating day in October approved FREE eligible based on income/household size information submitted on an application.
4-3.	(A.) Enter the number of applications on file as of October 1 and (B.) the number of students as of the last operating day in October approved REDUCED-PRICE eligible based on income/household size information submitted on an application.
4-4.	Total number of free or reduced-price applications on file as of October 1. This field is automatically calculated – no entry needed.

SECTION 5 – Verification Details
5-1.	Check box 5-1 if ALL schools and/or RCCIs in the LEA are exempt from verification activities. No further reporting is required in Section 5. Verification activities are NOT required for:
· Schools/RCCIs in which all children have been certified under direct certification procedures, including children documented as eligible foster
· Migrant, runaway, or homeless children
· RCCIs which do not have day students
· Schools operating the Community Eligibility Provision district-wide
· Schools participating in Provision 2 and are in a NON-BASE year district-wide
· Schools participating only in the Special Milk Program
· Schools which do not have any free or reduced price eligible students
5-2.	Indicate whether verification was performed and completed by the deadline of November 15. If verification was completed after the deadline, report the remainder of Section 5 as applicable. You must complete a Corrective Action Plan (CAP) in the space provided at the end of the report. The CAP will include information as to how you will prevent this from happening in future years.
5-3.	If verification was completed, check the type of verification process used. The total number of applications to verify will be automatically calculated.
· 3% Focused - Verify 3% or 3,000 of approved applications, whichever is less, selected from error-prone applications on file as of October 1. If there are not enough error-prone applications, LEAs must select at random additional applications to complete sample size.
· 3% Random - Verify 3% or 3,000, whichever is less, of all randomly selected approved applications on file as of October 1.
· 1% Plus ½% Focused - Verify the lesser of 1% or 1,000 approved applications on file as of October 1 selected from error-prone applications, PLUS the lesser of one-half of one percent or 500 approved applications on file as of October 1 that provided a case number in lieu of income.
5-4.	Report all applications on file as of October 1 considered error-prone. Error-prone applications are household applications approved as of October 1 indicating income within $1200 yearly; $100 monthly; $50 twice a month; $46 every two weeks; or $23 weekly of the annual limit of the applicable income eligibility guidelines.
5-5.	Enter the total number of applications initially selected for the verification process as indicated in 5-3.
5-6.	Check box 5-6 if direct verification was NOT conducted in the LEA (no schools and/or RCCIs in the LEA conducted direct verification).
5-7.	Enter the number of applications confirmed through direct verification. Only report applications and students if FREE or REDUCED-PRICE eligibility is confirmed through direct verification. Report applications and students NOT directly verified in the appropriate category in Section 6.
5-8.	If applicable in at least one school and/or RCCI, report all applications verified for cause outside of the verification process (7 CFR 245.6a) as of November 15. Applications verified for cause are NOT considered part of the required sample size. Include the results of verification for cause by original benefit type in the appropriate category in Section 6. Use red font for applications verified for cause.
For the purposes of this report, verification is complete for:
· Households whose eligibility does not change as of the date of the confirmation of eligibility by a reviewing official
· Households that do not appeal a change in eligibility as of the first operating day following the last date given for filing an appeal in response to a notice of change in eligibility
· Households that appeal a change in eligibility as of the first operating day following a decision by the hearing official

SECTION 6 – Results of Verification by Original Benefit Type
The number of applications reported in Section 6 should include both the results of verification from the verification process and the results from any applications verified for cause reported in 5-8. Use red font to report results of verification for cause. Do NOT report the results of applications that were Directly Verified in this section.
For each category, enter the application ID in the first column. You must assign an ID number to each application. Do NOT use actual household names. Place a ‘1’ in the column corresponding to the result of first verification review of the original benefit type and enter the number of students on the application.
*Responded: The household provided sufficient documentation. This includes verbal or written notification that the household declines benefits.*
*NO Response: The household did not provide sufficient documentation or the household did not provide a response.*
6-1.	Enter results of verification for applications where original approval was designated ‘Free – Categorically Eligible’. (Certified as FREE based on Basic Food/TANF/FDPIR documentation (e.g. case number) on application.)
6-2.	Enter results of verification for applications where original approval was designated ‘Free – Income’. (Certified as FREE based on income/household size on application.)
6-3.	Enter results of verification for applications where original approval was designated ‘Reduced-Price – Income’. (Certified as REDUCED-PRICE based on income/household size on application.)

SECTION 7 - Verification Totals Summary
This section is automatically calculated. No entry needed.

Corrective Action Plan
If verification was not completed by November 15, or the correct number of applications was not verified, a detailed Corrective Action Plan must be submitted. The corrective action plan must provide the steps to be taken to ensure the problem will not occur in future years.

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