Senior Farmers Market Nutrition Program

I certify that:

   I. I am:

             a. 60 years of age or older; AND

b. My monthly income is at or below the federal income guidelines for my household outlined in SFMNP Policy Memorandum #2025-1.

                      i. $2,413/month (for a one-person household): OR

                      ii. $3,261/month (for a two-person household): OR

                     iii. $4,109/month (for a three-person household)

  II. I have not received SFMNP checks from any other location this year

  III. I have been advised of my rights and obligations under the SFMNP.  I understand that I may appeal any decision made by the local agency regarding my  eligibility for the SFMNP.

  IV. The information I have provided for my eligility determination is correct, to the best of my knowledge. This certification form is being submitted in connection with the receipt of Federal assistance. Program officials may verify information on this form. I understand that intentionally making a false or misleading statement or intentionally misrepresenting, concealing, or withholding facts may result in paying the State agency, in cash, the value of the food benefits improperly issued to  me and may subject me to civil or criminal prosecution under State and Federal Law. 

Please allow 2-3 business days for processing. Farmers Market Coupons will be mailed to the address provided. 

• Each booklet is worth $25.00 and contains five (5) $5.00 coupons.
• Coupon color for this program year is lavender
• Eligibility is determined by age and income
• Each older adult in a household is eligible to receive a booklet if they meet the age and income requirements.