Emergency Food Assistance Program (TEFAP) – Family Eligibility Form

Fill out this form to determine your household’s eligibility for food assistance.

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***This table shows the monthly and weekly income limit for each family size. If your household income is at or below the income listed for the number of people in your household, you are eligible to receive TEFAP food.***

En esta tabla se muestra el límite de ingresos mensuales y semanales para cada tamaño de familia. Si los ingresos de su unidad familiar son iguales o inferiores a los indicados para la cantidad de personas que viven en dicha unidad, tiene derecho a recibir alimentos del programa TEFAP.

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Read below: I declare that the gross income of my household is equal to or less than the income listed for the number of people living in my household, as stated on this form. I declare that I live in the area served by the Emergency Food Assistance Program. This form is completed in connection with receiving federal assistance.