2017-2018

Lodi Unified School District

Online Free and Reduced Application

Letter to Household (Use the scrollbar to view the entire letter) PRINT

Lodi Unified School District – Nutrition Service Department

1305 East Vine Street, Lodi CA 95240 

LETTER TO HOUSEHOLDS ABOUT THE NATIONAL SCHOOL LUNCH PROGRAM
AND THE SCHOOL BREAKFAST PROGRAM FOR 2017-2018 SCHOOL YEAR

 

Dear Parent or Guardian:

The Lodi Unified School District takes part in the National School Lunch and/or School Breakfast Programs.  Meals are served every school day at participating schools.  Elementary students may buy lunch for $2.50 and/or breakfast for Free.  Middle & High school students may buy lunch for $3.00 and/or breakfast for Free. Eligible students may receive meals free or at a reduced price of $.40 for lunch and/or breakfast for Free.  Students may also buy milk for $.50.

  • Lodi Unified School District participates in Direct Certification:  your child is automatically certified to receive free meals, if your household currently receives Cal Fresh (formerly Food Stamps), or if your child receives California Work Opportunity and Responsibility to Kids (Cal Works), Kinship Guardianship Assistance Payments  (Kin-GAP), or Food Distribution Program on Indian Reservations (FDPIR) benefits.  Please contact LUSD Food Service Department if you have a child in your household not listed on the Direct Certification Letter.     
  • A foster care child who is the legal responsibility of the welfare agency or a ward of the court is eligible to receive free meals. (See “HOW TO APPLY – FOSTER CARE” below.)
  • If you do not receive benefits automatically qualifying your child for free meals, you may apply for free/reduced-price meals for your child(ren). If your total household income is the same or less than the amounts on the income scale below, your child may receive meals free or at a reduced price. “Household” means a group of related or non-related individuals who are living as one economic unit and sharing living expenses. “Living expenses” include rent, clothes, food, doctor bills, and utility bills. (See “HOW TO APPLY – INCOME HOUSEHOLDS” below.)

HOW TO APPLY

INCOME HOUSEHOLDS (wages, salary, pensions, etc.) — To apply for free or reduced-price meals for your child(ren), you must complete the attached Application for Free and Reduced-Price Meal every school year. Must sign and return it to the Nutrition Service Department as soon as possible or apply at www.lodiusd.schoollunchapp.com. The previous lunch application eligibility will expire on 9/11/17. The application cannot be approved unless it contains complete eligibility information.  You must enter the following:

  • The names of all school-age children in your household and the school(s) they attend
  • The names of all other children in your household who do not attend school
  • The names of all adults and other household members, the amount each person received last month, and the source of income
  • The last FOUR (4) digits of the Social Security number of any adult member of the household or indicate "none" if no adults have a Social Security number.

 

An application must be completed, with all household members and income listed, for a child who is living with relatives or friends, whether or not the child is a ward of the court. 

An adult household member must sign the application.

FOSTER CARE CHILDREN or CHILDREN PLACED IN OUT-OF-HOME CARE — who is the legal responsibility of the welfare agency or is a ward of the court. Households with foster and non-foster children may choose to include the foster child as a household member, as well as any personal income earned by the foster child, on the same household application that includes non-foster children. Write the name of the child and the specific school the child attends. If the child receives personal-use income, list the amount of income. The foster parent or agency official must sign the application.

FEDERAL INCOME CHART
For School Year 2017-2018

Household size Annual Monthly Twice per Month Every Two Weeks      Weekly
1 $22,311 $1,860 $930 $859 $430
2 $30,044 $2,504 $1,252 $1,156 $578
3 $37,777 $3,149 $1,575 $1,453 $727
4 $45,510 $3,793 $1,897 $1,751 $876
5 $53,243 $4,437 $2,219 $2,048 $1,024
6 $60,976 $5,082 $2,541 $2,346 $1,173
7 $68,709 $5,726 $2,863 $2,643 $1,322
8 $76,442 $6,371 $3,186 $2,941 $1,471
Each additional person: +$7,733 +$645 +$323 +$298 +$149

 

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits.  Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339.  Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

(1)      mail: U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW

 

CURRENT INCOME The amount of income each household member received last month, before taxes or anything else is taken out, and where it came from, such as earnings, welfare, pensions, and other income.  If any amount last month was more or less than usual, write the usual monthly income or project the annual income. 

INCOME TO REPORT

EARNINGS

FROM WORK

WELFARE

CHILD SUPPORT

ALIMONY

PENSIONS

RETIREMENT

SOCIAL SECURITY

OTHER INCOME

Wages, salaries and

tips, strike benefits, unemployment compensation, workers' compensation, net income from self-owned business or farm

Public assistance payments, welfare payments, alimony, and child support payments

Pensions, supplemental security income, retirement payments, Social Security Income (SSI) (including SSI a child receives)

Disability benefits; cash withdrawn from savings; interest and dividends; income from estates, trusts, and investments; regular contributions from persons not living in the household; net royalties and annuities; net rental income; any other income

FOOD DISTRIBUTION PROGRAM ON INDIAN RESERVATIONS (FDPIR) Households participating in the FDPIR are categorically eligible for free meals or milk. The FDPIR is authorized by Section 4(b) of the Food Stamp Act of 1977. Under this section, eligible households may elect to participate in either the Food Stamp Program or the FDPIR.  Since households are afforded the option to participate in either program, FDPIR households have been determined to receive the same categorical benefits as Food Stamp households.

SOCIAL SECURITY NUMBER The application must have the last FOUR (4) digits of the Social Security number of any adult member in the household or indicate "none" if no adults have a Social Security number. If a Cal Fresh, CalWORKs, Kin-GAP, or FDPIR case number for the child is listed, or if the application is for a foster child, a social security number is not required.

APPLYING FOR BENEFITS You may apply for benefits at any time during the school year.  If you are not eligible now but your income goes down, you lose your job, your family size becomes larger, or you become eligible for Cal Fresh, CalWORKs, Kin-GAP, or FDPIR benefits, you may submit an application at that time.

VERIFICATION — School officials may check the information on the application at any time during the school year. You may be asked to send information to prove your income, or current eligibility for Cal Fresh, CalWORKs, Kin-GAP, or FDPIR benefits.  Refer to the application for more detailed explanation.

MEALS FOR DISABLED — If you believe your child needs a food substitute or texture modification because of a disability, please contact the school. A child with a disability is entitled to a special meal at no extra charge if the disability prevents the child from eating the regular meal.

WIC PARTICIPANTS — If you currently receive benefits under the Special Supplemental Nutrition Program for Women, Infants, and Children—better known as the WIC Program—your child may be eligible for free or reduced-price meals. You are encouraged to complete an application and return it to the school for processing.

NONDISCRIMINATION Children who receive free or reduced-priced meals must be treated in the same manner as those children who pay full price for their meals. 

FAIR HEARING If you disagree with the result of your application you may discuss it with us; or the result of verification, you have the right to appeal. To ensure continued benefits while awaiting a hearing and decision an appeal must be filed within 10 calendar days of the mailed notice. You may request an appeal by writing to Mr. Warren Sun, Senior Director of Operations:

NAME: Warren Sun, Senior Director of Operations

ADDRESS: 1305 East Vine Street-Lodi CA 95240

TELEPHONE: 1-888-287-5873

CONFIDENTIALITY Family size, household income, and social security number information will remain confidential and will not be shared for any purpose.  Information you provide will determine your child(ren)’s eligibility to receive free or reduced-price meals.

If you have any questions or need assistance in completing the application, please contact:

NAME: Xee Moua or Leticia Gutierrez (Spanish)

ADDRESS: 1305 East Vine Street-Lodi CA 95240

TELEPHONE:  1-888-287-5873, 331-7278 or 331-7275

You will be notified when your application has been approved or denied for free or reduced-price meals.

 

Sincerely,

Nancy Rostomily          

Director of Nutrition Service Department

Lodi Unified School District