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Get TX CACFP Meal Benefit Income Eligibility Form (Child Care) 2011

NF, or FDPIR, provide the name and case number for the person who receives benefits. If no one receives these benefits, skip to part 3. NAME:_________________________________________________ CASE NUMBER: _________________________________ Part 3. (Applies only to parents/guardians with children enrolled in a day care home) If any member of your household receives benefits listed on the enclosed List of Eligible Federal/State Funded Programs (H1660), provide the name of the program and case numbe.

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