If you have any questions please contact MANNA at (828) or toll free

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1 DATE: November 21, 2017 TO: FROM: RE: All TEFAP Agencies Pat Williams TEFAP packet TEFAP information for the 1st quarter of 2018, January through March, can be downloaded from our website in its entirety the last week of December. Please make copies of the reporting form to use for each month, and please get your reports in to me by the 15 th of each month following your distribution. Be sure to use the new Client Eligibility form for and fill it out in its entirety once per year. Partial addresses are not acceptable. This is required by NCDA. Clients must sign for their TEFAP box/s each time they pick up. Always ask if anything has changed in their household. Client sheets must be stored at your pantry for a time period of FIVE years per NCDA. Freezer/Refrigerator temperatures must also be recorded daily. Your Civil Rights poster must be displayed in your pantry. If you do not have one please contact me and I will get one to you. All pantry staff and volunteers need to be aware of Civil Rights requirements and need to have had the Civil Rights Training. You must do this training one (1) time per year. All training and forms can be found on our website. See the last column of the monthly report for reporting TEFAP ending inventory for the month. You need to report this inventory in individual cans/units, not cases. It is important that we know your ending inventory each month to complete our tracking ability. TEFAP foods are eligible for the client choice program. If you chose to use client choice in your pantry, please advise the clients that they can choose which of the TEFAP items they would like to receive. When reporting clients served, please report only those clients who received TEFAP. TEFAP may be distributed to eligible clients as often as is needed but not more than once per week. NCDA and MANNA recommend that you use up all your last quarter items before ordering from the next quarter. When ordering, please do not order more than you need! The goal is to give out all you have by the end of each quarter. Please follow this guideline. YOU CAN DOWNLOAD THE ENTIRE PACKET FROM OUR WEBSITE. WE WILL BE UPLOADING IT THE LAST WEEK OF DECEMBER. IF YOU WOULD LIKE A PACKET MAILED/ ED PLEASE NOTIFY ME BY PHONE OR . Items allocated for this quarter are great northern beans, beef stew, farina wheat, mixed fruit, grape juice, macaroni, peanut butter, green peas, canned pork, canned sliced potatoes and vegetable soup. If you have any questions please contact MANNA at (828) or toll free Thank you very much. Pat MANNA FoodBank phone Swannanoa River Rd fax Asheville, NC mannafoodbank.org Involving, education, and uniting people in the work of ending hunger in Western North Carolina.

2 MANNA FOODBANK, ASHEVILLE, N.C. January, February, March 2018 TEFAP BALANCED DISTRIBUTION RATES Case lot distribution to agencies based on columns (4) (9) below will help assure that families get full variety and amounts based on N.C.D.A. guidelines. Agencies should distribute to families the full range of items the agency has in stock in the unit amounts per item listed in column (3). A balanced box assures you will run out of all products at the same time. Keep in mind that TEFAP foods are eligible for the client choice program. If you chose to use client choice in your pantry, please advise the clients that they can choose which of the TEFAP items they would like to receive. REVISED 11/21/2017 ITEM PACKAGING UNITS PER FAMILY SIZE 1-3 / 4+ ITEM NUMBER OF FAMILIES AGENCY PLANS TO SERVE (1) (2) (3) (4) (5) (6) (7) (8) (9) BEANS, GRT 12/2 # 1 / 2 BEANS, GRT NORTHERN NORTHERN BEEF STEW, CHUNKY 24/24 OZ 1 / 2 BEEF STEW, CHUNKY FARINA, WHEAT 10/18 OZ 1 / 2 FARINA, WHEAT FRUIT, MIXED 24/# 300 CAN 1 / 2 FRUIT, MIXED JUICE, GRAPE 8/64 OZ 1 / 2 JUICE, GRAPE PASTA, MACARONI PKG 1 / 2 PASTA, MACARONI PEANUT BUTTER 12/18 OZ 1 / 2 PEANUT BUTTER PEAS, GREEN 1 / 2 PEAS, GREEN PORK, CANNED 24/24 OZ 1 / 2 PORK, CANNED POTATOES, SLC, 1 / 2 POTAOTES SLC, CANNED CANNED SOUP, VEGETABLE 24/10.5 OZ 1 / 2 SOUP, VEGETABLE DISTRIBUTE ALL ITEMS FROM LAST QUARTER AT THE RATE OF 1 FOR HOUSEHOLDS OF 1 3 AND 2 FOR HOUSEHOLDS OF 4 OR MORE OR MAKE ALL BOXES THE SAME (one item per box) EXCEPT FOR APPLESAUCE WHICH IS 4/8 PER HOUSEHOLD. TO BE ABLE TO ORDER 144 YOU MUST BE THE ONLY TEFAP DISTRIBUTION SITE IN YOUR COUNTY. ***IF YOU WANT TO SERVE MORE CLIENTS YOU CAN PREPARE ALL BOXES USING THE 1-3 FAMILY SIZE REGARDLESS AS TO HOW MANY ARE IN THE FAMILY BUT YOU MUST STAY CONSISTENT WITH THIS DISTRIBUTION RATE THROUGH-OUT THE QUARTER. The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or if all or part of an individual's income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities. If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at or at any USDA office, or call (866) to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C , by fax (202) or at program.intake@usda.gov. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) ; or (800) (in Spanish). USDA is an equal opportunity provider and employer.

3 TEFAP 04a REVISED 12/20/17 MANNA FoodBank TEFAP DISTRIBUTION REPORT REPORT OF COMMODITIES FOR MONTH OF, 2018 AGENCY NAME AGENCY # PHONE # FAX # ADDRESS NAME AND TITLE OF PERSON COMPLETING THIS FORM REPORT DUE BY THE 15 Th OF THE NEXT MONTH *Reporting period runs from the 1 st day of the month to the last day of the month. *Fill in the invoice number and date in the grid below. Report the item/amount received in CASES. Record this amt in units/cans Week 1 Week 2 Week 3 Week 4 Week 5 END OF MONTH-inventory MONTH ENDING PHYSICAL INVENTORY (actual can/bag count) COMMODITY ENDING INVENTORY IN IND UNITS / CANS **PLEASE RECORD ACTUAL NUMBER OF INDIVIDUALS SERVED **RECORD ENDING MONTHLY INVENTORY IN LAST COLUMN NUMBER OF HOUSEHOLDS TOTAL NUMBER OF INDIVIDUALS - TOTAL **PLEASE RETURN THIS FORM TO THE FOOD BANK NO LATER THAN THE 15 TH OF THE NEW MONTH. IF YOU HAVE ANY QUESTIONS, PLEASE CALL PAT WILLIAMS AT (828)

4 ITEMS FROM LAST QUARTER Page 2 ( ) Item ( ) Item MONTH ENDING PHYSICAL INVENTORY (actual can/bag count) Ending Inventory

5 TEFAP Eligibility Form October 1, 2017 September 30, 2018 Name: Address: City: County: Number of People in Household: Foodstamps yes no Effective October 1, 2017 through September 30, 2018 (Household gross income must be at or below for appropriate size household.) HOUSEHOLD SIZE PER YEAR PER MONTH PER WEEK 1 $24,210 $2,010 $464 2 $32,496 $2,708 $625 3 $40,848 $3,404 $786 4 $49,200 $4,100 $946 5 $57,576 $4,798 $1,107 6 $65,928 $5,494 $1,268 7 $74,280 $6,190 $1,428 8 $82,656 $6,888 $1,590 EACH ADDITIONAL FAMILY MEMBER (+$8,376) (+$698) (+$161) The above table shows a yearly gross income 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 food. A household is defined as a group of people who live together and share money and other resources in order to get food. OR, if you currently participate in a Food & Nutrition Services Program (i.e. Food Stamps) you are automatically eligible to receive TEFAP and do not need to look at the income scale. Note: The above may be read to persons who are unable to read. People who are unable to sign their name may sign by using an X. Please read the following statement carefully, then sign the form and write in today s date. I understand that any misrepresentation of need, sale, or misuse of the foods I have received is prohibited and could result in a fine, imprisonment, or both. (Sec. 211 E, PL and Sec. 4C, PL as amended.) The section below is only for homebound individuals The following persons are authorized to pick up my food (if applicable): Authorized Representative: Authorized Representative: (Client Signature) () In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) Additionally, program information may be made available in languages other than English. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) Submit your completed form or letter to USDA by: (1) Mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C ; (2) Fax: (202) ; or (3) program.intake@usda.gov This institution is an equal opportunity provider.

6 FNS Yearly Income Monthly Income Weekly Income Agency Representative Signature Client Signature Yes No If you do not receive FNS Benefits (i.e. food stamps), write in your yearly, monthly, or weekly income if there has been a change In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) Additionally, program information may be made available in languages other than English. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) Submit your completed form or letter to USDA by: (1) Mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C ; (2) Fax: (202) ; or (3) program.intake@usda.gov This institution is an equal opportunity provider.

7 USDA/TEFAP ONE YEAR RECORDKEEPING/FOOD SAFETY AGREEMENT THE EMERGENCY FOOD ASSISTANCE PROGRAM (TEFAP) MANNA FOODBANK Agency # Agency County Agency Mailing Address I,, FROM (Your Name and Title) (Your Organization s Name) I understand the recordkeeping required for my agency to receive and distribute USDA commodities through the emergency food assistance program of USDA/NCDA and that there will be no shared-maintenance handling fee on these foods. All MANNA FoodBank emergency providers in good standing are eligible for TEFAP. Limits: 1. Commodities may be distributed to households as needed, but not more than once per week, based on the number of individuals in each household. 2. Agencies cannot store more than a three month supply of commodities at any given time. Eligibility criteria used: 200% of federal poverty line (USDA) Yearly Client Eligibility Form must be signed by certifying pantry representatives and recipient of commodities. You must keep this document on file for a period of FIVE years. Remember that each client must sign for their food each time they pick up. Refer to page 2 of the Yearly Eligibility Form. Product limits per number of persons in household apply and will be provided by MANNA FoodBank. Monthly inventory received/clients served report is required and due in MANNA s office by the 15 th of each month. Agencies that do not remit the monthly report will be suspended from the TEFAP program and may have food bank membership terminated if product cannot be accounted for. Pantries must have adequate food storage capabilities per regular criteria for agency participation as to temperature and distance from floor. TEFAP commodities must be stored separately from regular inventory. You must comply with these storage regulations when housing USDA commodities. Safe food handling and storage practices are required per regular criteria for agency participation and per MANNA FoodBank. Any and all frozen TEFAP commodities can never be repackaged for any reason. Damaged packages must be disposed of and reported on MANNA s TEFAP loss report. Partner agencies are required to attend MANNA s food safety training. Freezer and cooler temperatures are required to be checked and recorded daily to prevent food loss. The temperature log must be available for review for FIVE years. Federal non-discrimination poster must be displayed in your pantry. Staff and volunteers must review the Civil Rights Training yearly. I understand that failure to adhere to these requirements which include sending in a written report by the 15 th of each month will result in immediate suspension from the USDA TEFAP program. I will abide by these requirements with the understanding that our distribution records may be monitored by a representative from MANNA FoodBank or NCDA at any time. I understand that noncompliance with the record keeping for freezer/cooler temperatures could result in a claim for payment of any cooler/frozen food loss. Procedures must be in place to prevent a loss on dry goods which also could result in a claim for payment. (Agency Signature) (Title) () (Phone) (MANNA Food Bank Signature) (Title) () Revised 1/2013 Retain a copy of this agreement for your files and return original to: MANNA FoodBank 627 Swannanoa River Rd, Asheville, NC 28805