McComb Local School
328 South Todd Street · McComb, OH 45858 · 419-293-3979
Mr. Tony Fenstermaker, Superintendent · Mrs. Linda Clymer, Treasurer

Frequently Asked Questions About Free and Reduced-Price School Meals

Dear  Parent/Guardian:

Children need healthy meals to learn. The McComb LocalSchool offers healthy meals each school day. Breakfast costs
$1.25; lunch costs $2.25 (K-5) $2.55 (6-12). Your children may qualify for free  meals or for  reduced-price meals. Reduced price is $.30 for breakfast and $.40 for lunch. This packet includes an application for free or reduced-price meal benefits and a set of detailed instructions. Below are some common questions and answers to help you with the application process.
Who can receive free or raducad-prlce meals? All children in households receiving benefits from the Supplemental Nutrition Assistance Program (SNAP) or Ohio Works First (OWF);foster chlldren that are under the legal responsibility of a foster care agency or court; children participating in their school's Head Start program;and children who meet the definition of homeless, runaway, or migrant are eligible for free meals. Also, your children may receive free or reduced-price meals if your household's income is within the limits on the federal income eligibility guidelines.

FEDERAL ELIGIBILITY INCOME CHART FOR SCHOOL YEAR 2019-2020

1	$23,107	- -

$1,926	$445

Household size	Yearly	Monthly	Weekly
2	31,284	2,607	602
3	I	39,461	3,289	759

,4, 	

47,638	3,970	917

5	55,815	-

4,652	1,074

6	63,992	5,333	1,231
7	72,169	6,015	1,388
8	80,346	6,696	1,546
Each additional person:	8,177	682	158
How do Iknow if my children qualify as homeless, migrant or runaway? If members of your household lack a permanent address; are staying together in a shelter, hotel or other temporary housing arrangement; relocate on a seasonal basis or; children live with you who have chosen to leave their prior or family or household then the children may qualify as homeless, migrant or runaway. If you have not been told your children will receive free meals, please call or emall Mr. Tony Fenstermaker, homeless liaison or migrant coordinator at fenstermakert@mccombschool.org or 419-293-3979 ext. 401 to see if they qualify.

Do Ineed to fill out an appllcatlon for each chlld? No. Use one free and reduced-orice school mealapplication for all students i n y our household. We cannot approve an application that is not complete. Please submit all required information. Return the completed appllcatlon to Rlndl Schaublln, 328 S.Todd Streat, McComb, OH 45858, 419-293-3979 ext. 400.

Should Icomplete an appllcatlon If Ireceived a letter this school year saying my children are approved already for free meals? No, but please read the letter carefully and follow the instructions. If any children in your household were missing from the eligibility notification, contact RindiSchaublin, 328 S. Todd Street, McComb, OH 45858, schaubllnr@mccombschool.org or 419 293 3979 ext. 400 immediately.

Can Iapply onllne? Yes. You are encouraged to complete an online application instead of a paper application if possible. The online application has the same requirements and will request the same information as the paper application. Log Into your PaySchools Central lunch account or visit mccomblocalschools.payschools.com to begin or to learn more about the online application process. Contact Rindl Schaublin,
schaublinr@mccombschool.org, 419-293-3979 ext. 400 with any questions about the online application.

6. My chlld'• •ppllcatlon w•••pprovedl••t ye•r. Do InHd to complete mnother •ppllcatlon? Yes. Your child's application is valid for that schoolyear and for the first few days of this schoolyear. You are required to submit a new application unless the school notified you that your child is eligible for the new school year.
Ireceive WIC benefits. Can my chlld(ren) get free meals? Children in households participating In WIC may be
ellglble for free or reduced-price meals. Please submit a completed application.
Wiii thelnfonnatlon Igive be checked? Yes,we may also ask you to send written proof.
9.   If I do not qua lfy now, may Iapp ylater? Yes.You may apply at any time duringthe school year. For example, children with a parent or guardianwho becomes unemployed may become eligible forfree and reduced-price meals tf the household Income drops below the Income llmlt.
10. WhatIf Idl•agree with the school'•decision •bout my •ppllcation? You should talk to school officials. You also may ask for a hearing by calling or writing to the following contact person: Mr.Tony Fenstermaker.328 S. Todd Street, McComb,OH45858, 419-293-3979 ext. 401.

11. May IapplyIf someone else In my household Is not a U.S.citizen? Yes. You or your chlld(ren) members do not have to be a U.S..citizen to qualifyfor free or reduced-price meals.
What If myIncomeIs not always the urn•? List the amount that you normally receive.For example,if you normally make $1,000 each month, but you missed some work last month and only made $900, submit the report with the routine amount of $1,000 per month. If you normally get overtime, include It, but do not Include It tf you only work overtime sometimes. If you have lost a Job or had your hours or wages reduced, use your current Income.
What Ifsome houaehold members have noIncome to report? Household members may not receive some types of Income that are asked for you to report on the applicationor may not receiveIncome at all.When this happens, please write a O in the fleld. However,If any Income fields are left empty or blank, those also will be counted as zeroes. Please be carefulwhen leavlng Income fields blank.
14. We are In the mllltary.Do we report our Income dlfferently? Your basic pay and cash bonuses must be reported as Income. If you get any cash value allowances for off-base housing,food, or clothing, it also must be Included as Income. However, If your housing Is part of the Military Housing Privatization Initiative,do not include your housing allowance as income.Any additional combat pay resulting from deployment Is also excluded from income.

What Ifthere Is not enough space on the appllcatlon for my famlly? List any addltlonal household members on a separate piece of paper and attach it to your appllcatlon.Contact Rlndl Schaublln,328 South Todd street, McComb,OH 48858,419-293-3979 to receive a second application.
Why am Ibeing aakecl to give my conHnt for an inatructlonal fee waiver? Ohio public schools are required to waive the schoolinstructionalfees for children who quallty for free meal benefits. School food service personnel must have parent consent to share the student meal application if your chlld(ren) quality for a fee waiver.If you agree to allow your child(ren)'s meal application to be shared with schoolofficials to see If they qualify for a fee waiver then select Y• In part 5. If you do not wish for that information to be shared, then select no in part 5.
Answering no to this questionwlll mean your child wlll not be considered for a fee waiver. Answering this question either way will not change your child(ren)'s free or reduced-price meal ellglbtllty.

My famlly need• more help.Ara there other program• we might apply for? To find out how to apply for Ohio SNAP or other assistance benefits,contact your localassistance office or call 877-852-0010.

If you have other questions or need help,call 419-293-3979.
SI neceslta ayuda, por favor /lame a/ telilfono: 419-293-3979.
Si vous voudriez d'aide, contactez nous au numero: 419-293-3879.

Sincerely,
Mr.Tony Fen•termaker, Superintendent

"

INSTRUCTIONS FOR APPLYING
A household member is any child or adult living with you.

IF YOUR HOUSEHOLD RECEIVES BENEFITS FROM THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) OR OHIO WORKS FIRST (OWF), FOLLOW THESE INSTRUCTIONS:
Part 1:List all household members and the school name and grade level for each child.
Part 2: List the 7 or 10-digit case number for any household member (includlng adults} receiving SNAP or OWF benefits. Part 3: Skip this part.
Part 4: Skip this part.
Part 5: Answer yes or no and sign your name if you would like the application to be checked by school ofliclals to determine If the child(ren} qualifies for a school Instructional fee waiver.
Part 6: Sign the form. The last four digits of a Social Security Number are not necessary.
Part 7: We are required to ask for information about your children's race and ethnicity. This information is important and helps to make sure we are fully serving our community. Responding to this section is optional and does not affect your children's eligibility for free or reduced pr1ce meals.	
IF NO ONE IN YOUR HOUSEHOLD RECEIVES SNAP OR OWF BENEFrrs AND IF ANY CHILD IN YOUR HOUSEHOLD IS HOMELESS, MIGRANT OR RUNAWAY, FOLLOW THESE INSTRUCTIONS:
Part 1: List all household members and the school name and school grade level for each child. Part 2: Skipthis part.
Part 3: If any child you are applying for is homeless, migrant, or a runaway, check the appropriate box and call Mr. Tony Fenstermaker, HOMELESS LIAISON, or MIGRANT COORDINATOR at fenstarmakert@mccombschool .org or 419-293-3979. If not, skipthis part.
Part 4: Complete only if a child In your household isn't eligible under Part 3. See Instruction for all other households.
Part 5: Answer yes or no and sign your name if you would like the application to be checked by school officials to determine if the child(ren) qualifies for a school Instructional fee waiver.
Part 6: Sign the fonn. The last four digits of a Social Security Number are not necessary if you didn't need to complete in part 4.
Part 7: We are required to ask for information about your children's race and ethnicity. This information is important and helps to make sure we are fully serving our community. Responding to this section is optional and does not affect your children's eligibility for free or reduced once meals.	
	
IF YOU APPLY FOR A FOSTER CHILD, FOLLOW THESE INSTRUCTIONS:
If all chlldren In the household are foster children:
Part 1:List all foster children and the school name and grade level for each chlld.Check the box that indicates the child is a foster child. Part 2: Skip this part.
Part 3: Skip this part.
Part 4: Skip this part.
Part 5: Answer yes or no and sign your name if you would like the appllcatlon to be checked by school officials to determine if the child(ren) qualifies for a school instructional fee waiver.
Part 6: Sign the form. The last four digits of a Social Security Number are not necessary.
Part 7: We are required to ask for information about your children's race and ethnicity. This information is important and helps to make sure we are fully serving our community. Responding to this section is optional and does not affect your children's eligibility for free or reduced price meals.
If some of the chlldrenIn the hou1&hold are foster chlldren:
Part 1:List all household members and the school name and school grade level for each child. For any person, Including childran, with no income, you must check the "No Income" box. Check the box if the child is a foster child.
Part 2: If the household does not have a 7 or 10-digit SNAP or OWF case number, skip this part.
Part 3: If any child you are applying for is homeless, migrant, or a runaway check the appropriate box and call Mr. Tony Fenstermaker, HOMELESS LIAISON, or MIGRANT COORDINATOR at fenstennakert@mccombschool .org or 419-293-3979. If not, skip this part.
Part 4: Follow these instructions to report total household income from this month or last month.
Box 1-Name: List all household members with Income.
Box 2 -GrossIncome and how often it was received:For each household member, list each type of income received for the month. Check the appropriate box to note how often the person receives the income - weekly, every other week, twice a month, or monthly. For earnings, list the gross Income - not the take-home pay. Gross income is the amount earned before taxes and other deductions and can be found on pay stubs. For other income, list the amount and check the box to note how often each person received assistance from welfare, child support, alimony, pensions,retirement, Social Security, Supplemental Security
Income (SSI), Veteran's benefits NA benefits), and disability benefits. Under All Other Income, list Worker's Compensation, unemployment or strike benefits, regular contributions from people who do not live in your household, and any other income. Do not include income from SNAP, FDPIR, WIC, federal education benefits and foster payments received by the family from the placing agency. For ONLY the self-employed, report income after expenses under Earnings from Work. This is for your business, farm, or rental property. If you are in the Military Privatized Housing Initiative or receive combat pay, do not include these allowances as income.
Part 5: Answer yes or no and sign your name If you would llke the application to be checked by school offlclals to determine Ifthe
child(ren) qualifies for a school instructlonal fee waiver.
Part 6: Adult household member must sign the form and list the last four digits of their Social Security Number (or mark the box if he or she doesn't have one).	

Part 7: We are required to ask for information about your children's race and ethnicity. This Information is important and helps to make sure we are fully serving our community. Responding to this section is optlonal and does not affect your children's eligibility for free or reduced orlce meals.
ALL OTHER HOUSEHOLDS (INCLUDING WIC HOUSEHOLDS) FOLLOW THESE INSTRUCTIONS:
Part 1:List all household members and the school name and grade level for each child. For any parson, Including children, with no Income, you must check the •No Income Box.•
Part 2: If the household does not have a 7 or 10-digit SNAP or OWF case number,skip this part.
Part 3: If any child you are applying for Is homeless, migrant, or a runaway check the appropriate box and call Mr.Tony F1n1termaker, HOMELESS LIAISON, or MIGRANT COORDINATOR at fanstermakart@mccombschool.org or 419-293-3979. If not, skipthis part.
Part 4: Follow these Instructions to report total household Income from this month or last month.
Box 1- Name: List all household members with Income.
Box 2 -Gro11Income and how often It wa1 received: For each household member, Hat each type of income received for the month. Check the box to note how often the person receives the income - weekly, every other week, twice a month, or monthly. For earnings, be sure to Hat the gross Income - nottake-home pay. GroBS Income Is the amount earned before taxes and other deductions and can be found on pay stubs. Forother Income, list the amount and check the box to note how often each person received assistance from welfare, child support, alfmony, pensions, retirement, Social Security, Supplemental Security Income (SSI), Veteran's benefits r-JA benefits), and disablllty benefits. Under All Other Income, list Worker's Compensation, unemployment or strike benefit&, regular contributions from peoplewho do not live In your household,and any other income. Do not include income from SNAP, FDPIR,WIC, federal education benefits and foster payments received by the family from the piecing agency. For ONLYthe self-employed,report income after expenses under Earnings from Work. This Is for your business,farm,or rental property. If you are inthe Mllltary PrlvaUzed Housing Initiative or receive combat pay, do not Include these allowances as Income.
Part 5: Answer yes or no and sign your name If you would like the application to be checked by school omclals to determine if the
chlfd(ren) qualifies for a school Instructional fee waiver.
Part 8: An adult household member must sign the form and Hat the last four digits of their Social Security Number (or mark the box If he or she doesn't have one).
Part 7: We are required to ask for Information about your children's race and ethnicity. Thia Information la Important and helps to make
aure we are fully serving our community. Responding to this section is optional and does not affect your children's eligibility for free or reduced price meals.

2019-2020 FREE AND REDUCED-PRICE SCHOOL MEALS APPLICATION

Part 1.ALL HOUSEHOLD MEMBERS
--------------,N,..,a-_m_e_o-f=-sc..h,...oo,1.a-nd:-grade level   for   each

---------
Check If a foster chlld (legal reaponalblllty of	Check If

Names of !llhousehold members
(First, Mlddle Initial. Last)

child/or indicate "NA" Ifchild is not in school.

welfare agency or court)
*If all children listed below are foster children,	:00,e

1--------------+--S_ch_ooI	-..-_Grade -1 skil!to Part 5 to signth_ls..f.o._rm.------+-=--i
u	D
L.J	L.J
D	LI
D	D
D	D
D	D
D	D
Part 2. BENEFITS: If any member of your household receives Supplemental Nutrition Assistance Program (SNAP) or Ohio Works First (OWF) benefits, provide the name and 7 or 10-dlglt case number for the person who receives benefits and 1klp to Part Ii.If no one receives these benefits, aklp to Part 3.
NAME:	7 or 10-DIGIT CASE NUMBER:
Part 3. If any chlld you are applylng forla homeless,migrant.or a runaway check the appropriate box andcall Mr.Tony Fenstermaker, HOMELESS LIAISON,or MIGRANT COORDINATOR at fenstennakart@mccombschool.org or 419-293-3979.
Homeless D Migrant 0 Runaway D 	
Part<I.TOTAL HOUSEHOLD GROSSINCOME (before deductiona). List all income on the same line as the person who receives it.Check the
box for how often I t I s received. Record each lncom...;..;e.;...o.;;.;n..;.1;-Y-...O;;.nce..;..-------------------------
2. GROSSINCOME AND HOW OFTEN IT WAS RECEIVED

Earnings	>-  j	>- Welfare,	>-  $	>-  retirement,  t !c

' d'

Pensions,	j!	All Other Income

I

3:	3:  o  :c	Social	>	:5  (rn rcate irequency,

Nf

!

0

from work   ::1i12>
before	§

child
su.pport,

::i2
4§

Security,	> Ni

c:	such as "weekly"

deductions >

- alimony

> i;..-   o ..,

SSI,VA	>

'ui

,g "monthly" "quarterly"

1.NAME
!List all household members with lncome1

w i;..

"""

i1?1>i

'!i """
F-

benefits	w

i;..

"annually"

(Example) Jene Smith

$200	IBJ U ULJ	$150	U C?SI D D	$0	U U U D $50.00/ guartertv
$	U  LJ LJ  LJ $	LJ LJ LJ LJ $	0 D LJ u $	t 	

t-------------s---o·	D D D $	D D D D $	D D D D $	I	-
$	u u u u s	-	D O D-O S	LJ D O O S	'	-
$	D D D D $	D D D D $	tJ D DID $	I
$	0 0 0 0 $	D O D O S	-D D,D[ D $	1	,
Part 5.SCHOOLINSTRUCTIONAL FEE WAIVER ADULT CONSENT:Your child(ren) may qualify for a waiver of their school instructional fees. Your permission Is required to share your meal applrcabon information with school officials to determine 1f your child(ren) qualifies for a fee W81V81'. Answering this question will not change whether your children will receive free or reduced-price meals.
Please check a box:OYes, Iagree to have my meal application used to determine if my child(ren) qualifies for a fee waiver.
D No, I do not agree to have my meal appllcatlon used to determine If my child(ren) qualifies for a fee waiver.
Signature of Parent/Guardian:	Date:		_
Part 8.SIGNATURE AND LAST FOUR DIGITS OF SOCIAL SECURITY NUMBER (ADULT MUST SIGN)
An adult household member must sign the application.If Part " Is completed,the adult signing the fonn must also list thelast four digits of
his or her Social Security Number or mark the "Ido not have a Social Security Number'' box. (See Privacy Act Statement on the back of this page.)
I certify (promise) that ell Information on this application Is true and that all income isreported. I understand thet the school will receive federal funds based on the Information I give. I understand thst school otnclals may verify (check) ths lnformetfon. I understand that deliberate mlnf)f9Sentatlon of the Information may cause my children to lose 111681benefits end I may be subject to prosecution under state and federal
statutes.
Sign here:X	Print name:	Date:_	_
Address:'--------------------------	Phone Number :_		__

Last four digits of your SocialSecurity Number:

_ _ _ _	D Ido not have a Social Security N001ber

Part T, Chlldren'1ethnic and raclal ldentltlee: We are required to ask for Information about your cf'llldren's race and ethnicity. This Information Is Important and helps to make sure we are fully serving our community. Responding to this section is optional and does not affect your children's
ellglbilitv for free or reduced price meals.
Choose one ethnicity:	Choose one or more f reoardless of ethniciM:

D Not Hispani c/Latino	.....D...

White	DNative Hawaiian o-r other Pa-cific Islander ------

DHispanic/Latino	DAsian	OAmerican Indian or Alaska Native	DBlack or African American

t--------------

D-o'n-"o"'t-'-c''-o-mi-	this wtlon.Intended for mchool uuonl11.

Annual Income Conversion:  Wflfldy x 52, Every 2 Weeks x 26, Twioe A Month x 24, Monthly x 12
Total lnc:ame:	__ Per. 0 Wee/K., 0 Every 2 Weeki, 0Twtoe per Month, 0 Month, 0 Year	Household size: -

C8tegorlcal Ellglblllty: _	DateWithdrawn :	Ellglblllty: Free_
Determining/Approval or11c1ar1 Signature: Confirming Ofllcial'a Signature:
Follow-up Offlcla1'1Signature:

Reduced_

-
Denied_  Reason:-------

Date: -------
Date:---

---

-

-

Date: 	 _
If selected for Vertllcatlon, Date Verfflcatlon Notice Sant:

Response Date:

21111 Notice Sent

Reeu llSent: 	 _

Verification Reeult: No Change	Free to Reduced Price	Free to Paid	Reduced Price to Free	Reduced Price to Paid _

Your children may qualify for free or reduced-price meals if your household Income falls at or below the llmits on this chart.

INCOME ELIGIBILITY GUIDELINES 2019-2020
Household size		Yearly	Monthly	Weekly 1	$23,107	$1,926	$445
I	2	31,284	2,607	602
I	3	39,461	3,289	759
4	47,638	3,970	917

5	55,815	4,652	.

1,074

Privacy Act Statement: Thia
expl.ana how we wll UMthe
Information you glw ua.

6	63,992	5,333	1,231
-
7	72,169	6,015	1,388
8	80,346	6,696	1,546
Each additional person:	8,177	682	158

The Richard 8.Ruaell National School L.uich /id. requires theInformation on this applcatlon. You are not required to provide Information, but If Information la not provided, the state agency cannot approve your chlkl for free or reduced-price meals. You must Includethe last four digits of the 80Clal aecurtty number of the ach• household member who signsthe application.The last four  digits of the soclaf security number la notrequired when you apply on behalf of a foster child or you fist a Supplemental Nutrition Aaslatllnce Program (SNAP),Ohio Works First (OWF) caae number or other Identifier for your chlfd or when youIndicate that the
adult household member signing the appflcatlon dou not have a IOclal security number.Wewllf use your Information to determine ff your chlldIs ellglble for free or reduced-price meals,and for administration and enforcement of the lunch and breakfast programs.
We may 1hare your eflg bllfty Information with education,health, and nutrition programs to help them evafuate, fund, or determine
benefttlfor their programs, auditors for program reviews, and law enforcement ofllclals to help them lookInto vlolatfons of program
Nl81.
In accordance with Federal clvllrightslaw and U.S.Department of Agriculture (USDA) clvllrights regulatlon1and poflcles, the USDA, its Agencies, ofllcea, and employees, andInstitutions participating In or administering USDA programs are prohibited from discriminating based on raoe, color, natfonal origin, sex, dlaablllty,age, or reprisal or retallatlon for prior cfvll rtghtB acllvttyIn any program or activity conducted or funded by USDA.

Plll'80nawith dlsabllltles who require altematlve means of communication for program Information (e.g. Braille,large print, audiotape,American Sign Language,etc.), should contact the /4(Jancy (State orlocal) where they appl ed for beneftt1.lndlvlduals who are deaf, hard of hearing or have speech dlsablUtlea may contact USDA through the Federal Relay Service at (800) 877-8339. Addltlonafly, program Information may be madeavalable In languages other than English.
To Ille a progrwn complaint of dlscmllnatlon, complate the USDA Program Discrimination Complafnt Form, (AD-3027) found onh
at How lo Fiie a Complaint, and at any USDA ofllce,or wr1te a letter addressed to USDA and provide Inthe fetter all of the Information requested Inthe fonn.To requeet a copy of the complalnt form, call (886) 632-9992. Submit your completed fonn or letter to USDA by:
mall:	U.S. Department of Agriculture
Ofllca of the Assistant Secretary for CMIRights
1400 lndependenoe Avenue, SW Washington,  D.C.20250-9410;
(2)	fax:	(202) 690-7442; or
(3)	email:	program.lntake@usda.gov.
This Institution Is an equal opportunity provider.