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Your children may qualify for free FEDERAL INCOME CHART <br /> or reduced price meals if your For School Year 2007-08 <br /> household income falls within the Household size Yearly Monthly Weekly <br /> limits on this chart. 1 18,889 1,575 364 <br /> 2 25,327 2,111 488 <br /> 3 31,765 2,648 611 <br /> 4 38,203 3,184 735 <br /> 5 44,641 3,721 859 <br /> 6 51,079 4,257 983 <br /> 7 57,517 4,794 1,107 <br /> 8 63,955 51330 1,230 <br /> Each addit onal person: 6,438 537 124 <br /> Privacy Act Statement: This explains how we will use the information you give us. <br /> The Richard B. Russell National School Lunch Act requires the information on this application. You do not have to <br /> give the information,but if you do not,we cannot approve your child for free or reduced price meals. You must <br /> include the social security number of the adult household member who signs the application. The social security <br /> number is not required when you apply on behalf of a foster child or you list a Food Stamp Program,Temporary <br /> Assistance for Needy Families(TANF)Program or Food Distribution Program on Indian Reservations(FDPIR)case <br /> number or other FDPIR identifier for your child or when you indicate that the adult household member signing the <br /> application does not have a social security number. We will use your information to determine if your child is <br /> eligible for free or reduced price meals,and for administration and enforcement of the lunch and breakfast programs. <br /> We MAY share your eligibility information with education,health, and nutrition programs to help them evaluate, y <br /> fund,or determine benefits for their programs,auditors for program reviews, and law enforcement officials to help <br /> them look into violations of program rules. <br /> Non-discrimination Statement: This explains what to do if you believe you have been treated unfairly.In <br /> accordance with Federal law and U.S.Department of Agriculture policy,this institution is prohibited from <br /> discriminating on the basis of race,color,national origin,sex,age,or disability.To file a complaint of discrimination, <br /> write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue,SW, Washington DC 20250-9410 or call <br /> (800)795-3272 or(202)720-6382(TTY).USDA is an equal opportunity provider and employer. <br /> 66 <br /> February 2006 Free and Reduced Price School Meals Application <br /> Application <br /> Page 2 of 2 <br />