1.If you are on SNAP (food stamps) you are not eligible for Food Distribution Program. If you draw from both programs, you can be penalized and you will have to reimburse USDA for the cost of the food you received while you were ineligible.
IF YOU ARE ELIGIBLE FOR FOOD DISTRIBUTION, WE WILL NEED THE FOLLOWING INFORMATION TO ESTABLISH YOU IN OUR SYSTEM
LIST ALL HOUSEHOLD MEMBERS:
The date of birth and social security numbers for everyone in your household you are claiming on your application.
TRIBAL ID NUMBER:
This is NOT your fishing number.
Pay check stub for one month.
NO INCOME FORM:
For all unemployed applicants over the age of 18 and not in school.
SOCIAL SECURITY OR SOCIAL SECURITY INSURANCE; VETERANS BENEFIT; PENSION OR RETIREMENT; UNEMPLOYMENT; L&I, TANF, CHILD SUPPORT & FOSTER CARE etc.:
A copy of a check, award letter, or bank deposit slip.
A copy of award letter stating you are not receiving food stamps if switching programs.
A copy of award letter or check verifying how often monies are received.
A copy of check or award letter.
Reciept for child care for one month.
STANDARD SHELTER EXPENSE DEDUCTION:
Copy of your rent/mortgage receipt.
MEDICAL DEDUCTION FOR TRIBAL ELDERS:
Copy of any bills paid on a monthly basis.
A COPY OF YOUR UTILITY BILL:
We need the bill with your name and address so we are able to verify we have your correct address on file.
Please verify all income for the household and circle items wanted on the attached food order. If all attachments are not with the application, your application will be placed into a Pending file until all the required information is received and verified. Once you are certified eligible for food distribution we will add you to the delivery list for your area.
YOUR APPLICATION MUST BE ANSWERED HONESTLY AND COMPLETELY. PLEASE DO NOT LEAVE QUESTIONS BLANK AS THIS WILL DELAY YOUR CERTIFICATION.
Please return this applcation to the main SPIPA office located at:
3104 SE Old Olympic Hwy., Shelton WA 98584
or fax to: 360.427.8003
Serving: The Confederated Tribes of the Chehalis Reservation, Nisqually Indian Tribe, Port Gamble Klallam Tribe, Skokomish Indian Tribe, and Squaxin Island Tribe