Path

hns

Contact

Contact name or title

Health & Nutrition Services

Contact phone number

(602) 542-8700

Contact email address

[email protected]

Contact link

HelpDesk

Contact link

Contact the Department

FY24 Single Audit Qualifier Questionnaire

Current Organization Information
Single Audit Qualifier Questionnaire
Complete

Single Audit Qualifier Questionnaire Description

Description

This questionnaire will collect responses for the Child and Adult Care Food Program (CACFP) operators, National School Lunch Program (NSLP) Operators and Summer Food Service Program (SFSP) Community Organizations who do not complete their Single Audit Qualifying Questionnaire through Grants Management, and collect a copy of the single audit report for those who qualified for a single audit for fiscal year 2024 (FY 24). Arizona Department of Education, Health and Nutrition Services (HNS) will monitor the submissions.

All sponsors that received Federal funds from ADE are required to complete a Single Audit Qualifier Questionnaire to report to ADE if the annual amount of federal funds expended qualify the entity to conduct a single audit. Any entity that expends more than $750,000 in Federal funds in a fiscal year is required to hire an independent Certified Public Accountant (CPA) to conduct a single audit to review both the compliance and financial component of Federal programs. Operators must ensure the completion of the single audit is completed within 12 months after the close of the fiscal year.

Contact Information

First Name

Last Name

Position Title

Work/School Phone

Organization Information

CTDS Number

9-digit number assigned to your organization (6-digit number + 000)

Entity ID Number

Entity Name

County

REQUEST 2025 SUN BUCKS BENEFIT REVIEW/APPEAL

Special Assistance Provision 2/3 Base Year Application

Base Year Application

Please review the USDA Special Assistance Provision Manual and Online Course: How to Apply and Operate Special Assistance Provision 2/3 Base Year. Once completed, submit the application and required documents for review. Please note that this application is not approved until you receive an official letter of approval from this department. This application is due no later than June 30th annually.

LEA Information

Local Educational Agency (LEA) Name:

CTDS#

School Food Authority (SFA) Contact/Title:

SFA Email Address

Phone#:

Special Assistance Provision Participation

Indicate the Special Assistance Provision that will be operated (e.g. Provision 2 or 3):

Indicate the number of applying sites that will be participating in a base year:

Applying sites (as shown in CNPWeb)

Site 1

Site 1 Base Year

Site 1 Meal Participation

Select site's meal participation

Do you need to list a second site?

Second Site

Site 2

Site 2 Base Year

Site 2 Meal Participation

Select site's meal participation

Do you need to list a third site?

Third Site

Site 3

Site 3 Base Year

Site 3 Meal Participation

Select site's meal participation

Do you need to list a fourth site?

Fourth Site

Site 4

Site 4 Base Year

Site 4 Meal Participation

Select site's meal participation

List the legal name of applying sites (as shown in CNPWeb)

Applying sites (as shown in CNPWeb) File Upload

Attached the list of all sites by attaching file using the fields shown:

Please list site name(s) below, or indicate that a list of all sites is attached (if applying for more than four sites). The list needs to indicate the fields shown below on School District Letterhead.
One file only.
100 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

file fields

Legal name of applying sites (as shown in CNPWeb)
Base Year
Participation in BREAKFAST (B), LUNCH(L),OR BOTH (BL)

List the legal name of applying sites (as shown in CNPWeb)

Required Documents:

Document Links

Open each file (Application, Addendum, and Training), complete, save, and upload the files within this form by clicking 'Choose File' under the appropriate field below.

Special Assistance Application
Addendum- Provision 2
Addendum- Provision 3
Training Certificate: How to Apply and Operate Special Assistance Provision 2/3 Base Year

Special Assistance Application

One file only.
100 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Addendum

Training Certificate

I CERTIFY

Name (authorized signatory):

Date:

I CERTIFY that the information in this application is true, and that I agree to carry out the terms of the agreement to operate the Special Assistance Program. I understand that this information is given in connection with the receipt of federal funds and that deliberate misinterpretation may be subject to prosecution under applicable federal statutes.

Guía de evaluación de elegibilidad de SUN Bucks ((Beneficios de Verano)

SUN Bucks: Transferencia Electrónica de Beneficios de Verano (Summer-EBT):

El Programa de Transferencia Electrónica de Beneficios de Verano (Summer-EBT/SUN Bucks) proporciona beneficios para la compra de alimentos a familias de bajos ingresos con niños en edad escolar que pierden el acceso a comidas escolares gratuitas o a precio reducido cuando las escuelas están cerradas durante el verano.

A partir de 2025, las familias de Arizona recibirán $120 por niño elegible para comprar alimentos durante los meses de verano, cuando la escuela no está en sesión.

Use esta herramienta de evaluación para determinar si su hijo es elegible para SUN Bucks (también conocido como Summer EBT).

¡Vamos a empezar!

NSLP School List

Asegúrese de completar este formulario individualmente para cada niño en su hogar. La elegibilidad puede variar según el niño.

Este formulario no recopilará ninguna información identificativa sobre usted o su familia.

Debería tomar menos de 5 minutos para completarlo.

¿Está su hijo inscrito en una escuela que participa en el Programa Nacional de Almuerzos Escolares (NSLP) en los años escolares 2024-2025?

Si no está seguro de si su hijo está inscrito en una escuela NSLP/SBP, consulte la lista de escuelas NSLP/SBP arriba.

PowerBi

Mire Esta Lista de Escuelas del Programa Nacional de Almuerzos Escolares (NSLP)/Programa de Desayunos Escolares (SBP) que Participan en el Año Escolar 2024-2025

Program Participation

Programs

¿El estudiante participó en alguno de los siguientes programas durante uno o más días entre el 1 de Julio de 2024 y el 5 de Agosto de 2025?

Programa de Asistencia Nutricional Suplementaria (SNAP),
Asistencia Temporal para Familias Necesitadas (TANF),
Medicaid con un ingreso familiar igual o inferior al 185% del nivel de pobreza federal (antes de deducciones),
El estudiante es un niño de crianza, certificado para el Programa de Educación para Migrantes o el Programa de Educación para Personas sin Hogar,
El estudiante está inscrito en un Head Start que participa en el NSLP/SBP

¿Está su estudiante participando en alguno de los siguientes programas?

¿Cómo recibió su hijo comidas gratuitas o a precio reducido durante el año escolar 2024-2025? 

¿Tenía su hijo entre 6 y 16 años en algún momento entre el 1 de julio de 2024 y el 30 de junio de 2025?

2Program Participation

Programs

¿El estudiante participó en alguno de los siguientes programas durante uno o más días entre el 1 de Julio de 2024 y el 5 de Agosto de 2025?

Programa de Asistencia Nutricional Suplementaria (SNAP),
Asistencia Temporal para Familias Necesitadas (TANF),
Medicaid con un ingreso familiar igual o inferior al 185% del nivel de pobreza federal (antes de deducciones),
El estudiante es un niño de crianza, certificado para el Programa de Educación para Migrantes o el Programa de Educación para Personas sin Hogar,
El estudiante está inscrito en un Head Start que participa en el NSLP/SBP

¿Está su estudiante participando en alguno de los siguientes programas?

Household Income

Su hogar generalmente incluye a todos los que viven bajo el mismo techo y con quienes comparte los alimentos.

Su hogar generalmente incluye a todos los que viven bajo el mismo techo y con quienes comparte los alimentos.

Tamaño del hogar: ............. Límite de ingreso anual:

2 personas ............................... $39,128

3 personas ............................... $49,303

4 personas ............................... $59,478

5 personas ............................... $69,653

6 personas ............................... $79,828

7 personas ............................... $90,003

8 personas............................... $100,178

¿Es el ingreso anual de su hogar menor que la cantidad indicada en la tabla anterior?

2Household Income

Su hogar generalmente incluye a todos los que viven bajo el mismo techo y con quienes comparte los alimentos.

Su hogar generalmente incluye a todos los que viven bajo el mismo techo y con quienes comparte los alimentos.

Tamaño del hogar: ............. Límite de ingreso anual:

2 personas ............................... $39,128

3 personas ............................... $49,303

4 personas ............................... $59,478

5 personas ............................... $69,653

6 personas ............................... $79,828

7 personas ............................... $90,003

8 personas............................... $100,178

¿Es el ingreso anual de su hogar menor que la cantidad indicada en la tabla anterior?

This child is likely eligible for SUN Bucks - Free School Meals

El Niño Probablemente Es Elegible – Certificado Como Gratuito o a Precio Reducido Por La Escuela

Debido a que este niño está certificado para recibir comidas escolares gratuitas o a precio reducido, será inscrito automáticamente en el programa SUN Bucks. Para recibir los beneficios, por favor asegúrese de que la escuela de su hijo tenga su dirección postal actual en el archivo.

Si tiene hijos adicionales, por favor repita este formulario para determinar si los hijos adicionales son automáticamente elegibles para SUN Bucks o si se requiere una Solicitud Familiar de SUN Bucks 2025.

Por favor, tenga en cuenta: este resultado es una estimación basada en la información que proporcionó sobre este niño. El Departamento de Educación de Arizona toma todas las decisiones finales de elegibilidad para SUN Bucks

Aprenda más sobre SUN Bucks aqui.

This child is likely eligible for SUN Bucks - Program Assistance

Este Niño Probablemente Sea Elegible Para SUN Bucks - Programas de Asistencia.

Debido a que este niño está inscrito en programas de asistencia pública que califican, es automáticamente elegible para SUN Bucks y no necesita someter una Solicitud de Hogar SUN Bucks 2025. Para recibir los beneficios, asegúrese de que su dirección postal sea correcta en todos los programas de asistencia pública.

Aprenda más sobre SUN Bucks aqui.

2This child is likely eligible for SUN Bucks - Program Assistance

This child is likely eligible for SUN Bucks - Program Assistance

Este Niño Probablemente Sea Elegible Para SUN Bucks - Programas de Asistencia.

Aprenda más sobre SUN Bucks aqui.

This Child Is Likely Eligible but needs to Submit an Application

El Niño Probablemente es Elegible, Pero Necesita Someter Una Solicitud

Basado en la información proporcionada para este niño, deberá someter una Solicitud de Hogar SUN Bucks 2025 a través del Departamento de Educación de Arizona para solicitar el beneficio. La Solicitud de Hogar SUN Bucks 2025 se puede encontrar aquí y debe presentarse antes del 5 de agosto de 2025. La solicitud presentada será revisada, y si se determina que el(los) niño(s) en la solicitud son elegibles, el beneficio de $120 SUN Bucks se enviará por correo a la dirección proporcionada en la solicitud.

Aprenda más sobre SUN Bucks aqui.

2This Child Is Likely Eligible but needs to Submit an Application

This Child Is Likely Eligible but needs to Submit an Application

El Niño Probablemente es Elegible, Pero Necesita Someter Una Solicitud

Aprenda más sobre SUN Bucks aqui.

This child is likely not eligible for Sun Bucks

El Niño Probablemente No Es Elegible

Si su familia necesita ayuda con alimentos este verano, puede visitar un sitio participante del servicio de alimentos de verano cerca de usted y acudir al sitio durante el horario de servicio de comidas Sitio de Comidas Gratuitas de Verano. Los sitios participantes están abiertos a todas las familias con niños de 18 años o menos, el programa de Comidas Gratuitas de Verano no solicita ningún papeleo, sin preguntas. Encuentre un sitio cerca de usted aquí.

2This child is likely not eligible for Sun Bucks

This child is likely not eligible for Sun Bucks

El Niño Probablemente No Es Elegible

3This child is likely not eligible for Sun Bucks

This child is likely not eligible for Sun Bucks

El Niño Probablemente No Es Elegible

4This child is likely not eligible for Sun Bucks

This child is likely not eligible for Sun Bucks

El Niño Probablemente No Es Elegible

Child may or may not be eligible for Sun Bucks

Your Child may or may not be eligible for Sun Bucks

Su Hijo Podría No Podría Ser Elegible Para SUN Bucks

Desafortunadamente, no tenemos suficiente información para determinar si este niño recibirá SUN Bucks o no. Puede someter una Solicitud de Hogar SUN Bucks 2025 a través del Departamento de Educación de Arizona para solicitar el beneficio. La Solicitud de Hogar SUN Bucks 2025 se puede encontrar aquí y debe someterse antes del 5 de agosto de 2025. La solicitud sometida será revisada, y si se determina que el(los) niño(s) en la solicitud son elegibles, el beneficio de $120 SUN Bucks se enviará por correo a la dirección proporcionada en la solicitud.

Aprenda más sobre SUN Bucks aqui.

2Child may or may not be eligible for Sun Bucks

Your Child may or may not be eligible for Sun Bucks

Su Hijo Podría No Podría Ser Elegible Para SUN Bucks

Aprenda más sobre SUN Bucks aqui.

SUN Bucks Eligibility Screener Guide

SUN Bucks: Summer Electronic Benefit Transfer (Summer-EBT)

Summer Electronic Benefit Transfer Program (Summer-EBT/SUN Bucks) provides grocery-buying benefits to low-income families with school-aged children who lose access to free or reduced-price school meals when schools are closed for the summer.

Starting in 2025, Arizona families will receive $120 per eligible child to purchase groceries during the summer months, when school is out of session.

Use this tool to determine if your child is:

1.) eligible for SUN Bucks (also known as Summer EBT) or

2.) OPT OUT of receiving the benefit. If you wish to opt out, please visit this webpage and check the "I would like to opt out of receiving Summer EBT benefits" once you enter the student information.

Let's Get Started!

NSLP School List

SUN Bucks Eligibility Screener Guide

The following form is a screener tool to help avoid unnecessary efforts for households. Many households are automatically eligible for SUN Bucks, and this tool ensures households who are already eligible do not complete a 2025 SUN Bucks Household Application when it is not required. Completion of the SUN Bucks Eligibility Screener Guide will provide the link to the SUN Bucks Household Application if applicable.

Please be sure to complete this screener for each child in your household. Eligibility may vary by child.

This form will not collect any identifying information about you or your family. It should take under 5 minutes to complete.

Is your child enrolled in a school that participates in the National School Lunch Program (NSLP) in the 2024-2025 School Years

If you are unsure if your child is enrolled in an NSLP/SBP School, please see the NSLP/SBP School list below.

PowerBi

View this List of National School Lunch Program (NSLP)/School Breakfast Program (SBP) Schools Participating in School Year 2024-2025

or search using the below table:

Program Participation

Programs

Was the student participating in any of the following programs for one or more days between July 1, 2024 through August 5, 2025?

Supplemental Nutrition Assistance Program (SNAP),
Temporary Assistance for Needy Families (TANF),
Medicaid with a household income at or below 185% of the federal poverty level (before deductions),
Student is a foster child, certified for the Migrant Education Program or Homeless Education Program,
Student is enrolled in a Head Start that participates in the NSLP/SBP

Is your student participating in any of the following programs?

How did your child receive free or reduced meals during the 2024-2025 school year

Was your child 6-16 years old anytime between July 1, 2024 - June 30, 2025

2Program Participation

Programs

Was the student participating in any of the following programs for one or more days between July 1, 2024 through August 5, 2025?

Supplemental Nutrition Assistance Program (SNAP),
Temporary Assistance for Needy Families (TANF),
Medicaid with a household income at or below 185% of the federal poverty level (before deductions),
Student is a foster child, certified for the Migrant Education Program or Homeless Education Program,
Student is enrolled in a Head Start that participates in the NSLP/SBP

Is your student participating in any of the following programs?

Household Income

Your household is typically everyone who lives under the same roof and that you share groceries with.

Your household is typically everyone who lives under the same roof and that you share groceries with.

Household size: ............. Yearly Income Limit:

2 people ............................... $39,128

3 people ............................... $49,303

4 people ............................... $59,478

5 people ............................... $69,653

6 people ............................... $79,828

7 people ............................... $90,003

8 people ............................... $100,178

Is your household's annual income less than the amount listed in the table above?

2Household Income

Your household is typically everyone who lives under the same roof and that you share groceries with.

Your household is typically everyone who lives under the same roof and that you share groceries with.

Household size: ............. Yearly Income Limit:

2 people ............................... $39,128

3 people ............................... $49,303

4 people ............................... $59,478

5 people ............................... $69,653

6 people ............................... $79,828

7 people ............................... $90,003

8 people ............................... $100,178

Is your household's annual income less than the amount listed in the table above?

This child is likely eligible for SUN Bucks - Free School Meals

Child Is Likely Eligible – Certified as Free or Reduced-Price by School

Because this child is certified to receive free or reduced-price school meals, they will be automatically enrolled in the SUN Bucks program. To receive benefits, please ensure that your child's school has your current mailing address on file.

If you have additional children, please repeat this form to determine if additional children are automatically eligible for SUN Bucks or if a 2025 SUN Bucks Household Application is required.