WEST VIRGINIA DEPARTMENT OF EDUCATION
Program Year 2004-2005
SCHOOL VERIFICATION SUMMARY REPORT
Overview and Instructions For Report Completion
Overview of School Verification Summary Report
All schools operating the National School Lunch Program (NSLP) and/or
the School Breakfast Program (SBP) must submit the information found on
the School Verification Summary Report to the School Food Authority
(SFA) no later than December 15, 2004.
The following is a brief description of the two parts that comprise the
School Verification Summary Report:
Part I of the report contains enrollment, application, and eligibility
information on file at the school on the last operating day in October. The
sampling method (random or focused) and size of sample for the
verification process is also indicated in this part of the Summary Report.
Part II of the School Verification Summary Report documents the results of
the verification process. The number of applications, as well as the
number of students included on each application, is indicated for the
following categories:
-
No Change:
Status remains the same
-
Increase in Benefits: Reduced changed to Free
-
Decrease in Benefits: Free changed to Reduced
OR
Free or Reduced changed to Paid
-
Did Not Respond:
Changed to Paid
Instructions for Completing the School Verification Summary Report
Part I.
Enrollment, Application, and Eligibility Information
Question 1:
Mark the sampling method used for the verification process. Report the date of application selection for
verification on the line below Question 1.
Question 2:
Report the number of applications verified for the chosen sampling method. Give the date of completion
of the verification process and whether verification documentation is on file at the school on the lines
below Question 1.
Question 3:
Report the school enrollment on the date of application selection.
Question 4: Eligibility Reporting for Free
4A: Report the total number of students approved as free eligible through direct certification.
4B: Report the total number of students approved as free eligible based on a Food Stamp or TANF
case number submitted on the application. (categorically eligible free)
4C: Report the total number of students approved as free eligible based on household size and
income information submitted on an application.
Question 5: Eligibility Reporting for Reduced
Report the total number of students approved as reduced price eligible based on household size and
income information submitted on an application.
Question 6: Application Reporting
Report the number of Applications on file the day of selection:
A.
Categorically eligible FREE applications
B.
Income eligible FREE applications
C.
Income eligible REDUCED applications
Continues on Back
Instructions For Completing the School Verification Summary Report
Part II. Verification Results, by Application Type
NOTE:
Application types include:
- Categorically Eligible Free: eligible for free benefits based on a Food Stamp or
TANF case number submitted on an application
- Income Eligible Free:
eligible for free benefits based on household size and
income information submitted on an application
- Reduced Price Eligible:
eligible for reduced benefits based on household size
and income information submitted on an application
Question 7:
7A: Report the number of applications with NO CHANGE in eligibility.
7B: Indicate the number of students on these applications, for each of the following application
types: categorically eligible free (Food Stamp or TANF), income eligible free, and income eligible
reduced price.
Question 8:
8A: Report the number of applications for which there was an INCREASE in benefits. The eligibility
status was changed from REDUCED TO FREE based on documentation provided by the household.
8B: Indicate the number of students affected on these applications.
Question 9:
9A: Report the number of applications for which there was a DECREASE in benefits. The eligibility
status was changed from FREE TO REDUCED price based on documentation provided by the
household.
9B: Indicate the number of students affected who were previously categorically eligible free or
income eligible free.
Question 10:
10A: Report the number of applications for which there was a DECREASE in benefits. The eligibility
status was changed from FREE OR REDUCED TO PAID based on documentation provided by the
household.
10B: Indicate the number of students affected who were previously categorically eligible free,
income eligible free, or income eligible reduced price.
Question 11:
11A: Report the number of applications for which the eligibility was CHANGED TO PAID because
the household did not respond.
11B: Indicate the number of students affected who were previously categorically eligible free,
income eligible free, or income eligible reduced price.