Get Revised 950-05 Fmnp Shippment Confirmation.doc - Cdph Ca

Filling out the Revised 950-05 FMNP Shipment Confirmation form is essential for documenting the receipt of Farmers' Market Nutrition Program check booklets. This guide will provide you with clear, step-by-step instructions to ensure that you complete the form accurately and efficiently online.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Start by entering the date on which you received the shipment in the designated field. This helps establish the timeline for the transaction.
3. Next, fill in the 'Agency Number' section with the unique identification number assigned to your agency.
4. In the 'Agency Name' field, provide the official name of your agency ensuring that it matches your registered documentation.
5. Input the 'Shipping Address' where the check booklets were delivered. Ensure this information is accurate to avoid any discrepancies.
6. Indicate the 'Number of Check Booklets Sent'. This should reflect the total number of booklets you received in this shipment.
7. For the 'Serial Number Range', enter the starting and ending serial numbers for each booklet range, ensuring they match the packing slip and the shipping box labels.
8. Obtain the signature of the primary staff person who is receiving the FMNP check booklets and record their name and date of receiving.
9. If applicable, also have the secondary staff person sign the form, recording their name and the date as well.
10. Once all fields are correctly filled out, review the form for accuracy before proceeding to save your changes.
11. Finally, download, print, or share the completed form as instructed, and ensure to email it to wicfmnp@cdph.ca.gov or fax to 916-263-3314.

Complete the Revised 950-05 FMNP Shipment Confirmation form online today to ensure prompt processing of your shipment.