Verification Collection Report 3-12-4 171020

Verification Collection Report

Practice Template
Verification Report opens in TX-UNPS November 7, 2018.

The SFA Verification Report in TX-UNPS is due February 1, 2019.
Instructions: Use this practice verification template to collect all the data necessary to complete the Verification Report before it opens in TX-UNPS on November 7th.

This practice report will provide warnings and helpful tips that will help you complete the actual report without any errors that lead to possible findings and corrective actions.
Name

First NameLast Name
Phone Number
E-mail
example@example.com
General Information

Verification Contact Information
Contracting Entity (CE) Name*
CE Identification Number (CE ID)*
5-Digit number used in TX-UNPS
Type of Organization*
This is automatically completed on the report.

Please note -- the contact information will be automatically filled in with the Child Nutrition Director information from the Application Packet.

If this is not the contact for verification information, please update it. It does not have to be the child nutrition director. It should be the person responsible for submitting the report.

Verification Contact Information
1. Name:*

Salutation First NameLast Name
2. Email:*
3. Phone:*
4. Title:
Instructions:
ANNUALLY, each SFA, including ALL RCCIs, with schools operating the National School Lunch Program (NSLP) and/or School Breakfast Program (SBP) must report verification information. All SFAs, including SFAs with all schools exempt from verification requirements, must complete applicable sections.

NOTE: SFAs that are Special Milk Only are exempt from filing an SFA Verification Collection Report.
Section 1 - Total Schools, Residential Child Care Institutions (RCCIs), and Enrolled Students
All SFAs must report Section 1. Report schools or institutions operating the NSLP and/or SBP as of the last operating day in October.
1-1 Total Schools (Do not include RCCIs):
5. (1-1A) Total Schools or Institutions
6. (1-1B) Total Number of Students
Do any sites participate in Community Eligibility Provision (CEP) or Provision 2 (P2)?*

CEPProvision 2No
Is this a base year for Provision 2

YesNo
How many sites participate in CEP or Provision 2?*
Enter the number of schools that are designated as CEP
Are any sites designated as RCCI?*

YesNo
DC/Verification Check
1-2 Total RCCIs (Do not include schools counted in 1-1):
7. (1-2A) Total Schools or Institutions
RCCI
8. (1-2B) Total Number of Students
Enrolled in all RCCIs
Total students
1-2a RCCIs with Day Students (Report only day students in 1-2aB)
9. (1-2aA) RCCIs with day students
RCCI with day students
10. (1-2aB) Number of Students
Report only DAY students

Total RCCI institutions
1-2b RCCIs with NO Day Students
11. (1-2bA) RCCIs
RCCI with NO day students
12. (1-2bB) Number of Students
Do not include any day students

Cannot report students in zero schools and/or RCCIs. Please correct the numbers in Section 1.
Total Students (Schools and RCCIS)
Total Institutions
Difference

Section 2 - SFAs with schools operating alternate provisions
Only SFAs with alternate provisions must report Section 2. Report schools or institutions operating the NSLP and/or SBP as of the last operating day in October.
13. 2-1 A: Operating Provision 2/3 in a BASE year for NSLP and SBP
Number of Schools OR Institutions
14. 2-1 B: Operating Provision 2/3 in a BASE year for NSLP and SBP
Number of Students
15. 2-2 A: Operating Provision 2/3 in a NON-BASE year for NSLP and SBP
Number of Schools OR Institutions
16. 2-2 B: Operating Provision 2/3 in a NON-BASE year for NSLP and SBP
Number of Students

P2 Free Plus Reduced check
17. 2-2aB Provision 2/3 students reported as FREE in a NON Base year:
13

18. 2-2bB Provision 2/3 students reported as REDUCED PRICE in a NON Base year:
14

19. 2-3 A. Operating the Community Eligibility Provision (Sites)
Number of Schools OR Institutions
20. 2-3 B. Operating the Community Eligibility Provision (Students)
Number of Students
RCCI/CEP Check
RCCI/CEP Check 2

Note: 2-4 and 2-5 are read-only because they are not applicable, but are still on the Verification Report.

If you do operate an alternative provision program for only SBP or NSLP, please contact your regional ESC for instructions.
2-4 A. Operating other alternatives for NSLP/SBP (Sites)
Number of Schools OR Institutions
2-4B. Operating other alternatives for NSLP/SBP (Students)
Number of Students
2-5 A. Operating an alternative provision(s) for only SBP or only NSLP (Sites)
Number of Schools OR Institutions
2-5 B. Operating an alternative provision(s) for only SBP or only NSLP (Students)
Number of Students

Section 3 - Students approved as FREE eligible NOT subject to verification
All SFAs must report Section 3 or check box 3-1 if applicable. Report students approved FREE eligible as of the last operating day in October.
The following CEs will check box 3-1. Checking the box "turns off" section 3.
- RCCIs with no day students
- RCCIs with day students that remain enrolled at the home district
- CEs that all sites participate in either CEP or P2
Check the box only if ALL schools and/or RCCIs in the SFA were not required to perform direct certification with SNAP (i.e. NON BASE year Provision 2/3 or CEP for all sites).
21 (3-1) Not required to perform Direct Certification

3-1 No DC

3-2 Students directly certified through Supplemental Nutrition Assistance Program (SNAP):

You have indicated that you were not required to do perform direct certification (3-1 - checkbox 21). If this is not correct and you need to report the number of students directly certified with SNAP at sites not participating in CEP or Provision 2, uncheck 3-1 (checkbox 21).

22 (3-2) SNAP
Please note: These are only the students at sites NOT participating in CEP or P2
Enrollment check
Report students directly certified through other programs in 3-3. This includes
- Temporary Assistance for Needy Families (TANF)
- Medicaid-Free
- Food Distribution Program on Indian Reservations (FDPIR)
- Documented Homeless
- Documented Migrant
- Documented Runaway
- Documented Foster
- Head Start
- Pre-K Even Start
- Non-Applicant but approved by local officials
DO NOT include SNAP students already reported in 3-2.

DO NOT include directly certified MEDICAID Reduced Price.
3-3 Students directly certified through other programs:
23 (3-3) DC other:

3-4 Students certified categorically FREE eligible through SNAP letter method.
24 (3-4) SNAP Letter
This is not a valid method of direct certification. The entry must be 0.

Section 4 - Students approved as FREE or REDUCED PRICE eligible through a household application

ALL SFA collecting applications must report Section 4. Report number of applications (A) approved as of October 1st. Report number of students (B) as of the last operating day of October.
4-1. Approved as categorically FREE Eligible. Based on those providing documentation (e.g. a case number of SNAP, TANF, FDPIR on an application)
25. 4-1A Total Applications as of Oct 1
26 4-1B Number of Students as of Oct 31
4-1 Number of students per application
student/application check

The number of applications does not change if the students' eligibility changes- e.g. if a student on a categorically eligible application is directly certified during the month of October, the number of applications will remain the same, but the number of students will be only those that are on the application as of October 31st. It is possible to have fewer students than applications.

4-2 Approved as FREE Eligible. Based on household size and income information.
27 (4-2A) Total Applications Oct 1
28 (4-2B) Number of Students Oct 31
4-2 Number of students per application
student/application check

4-3 Approved as REDUCED PRICE Eligible. Based on household size and income information.
29 (4-3A) Total Applications Oct 1
30 (4-3B) Number of Students Oct 31
4-3 Number of students per application
student/application check

Warning: You are reporting an average of 6+ students per application for the categorically eligible FREE applications. Even with the different reference dates for these two fields (Oct 1 vs. Oct 31), this is unexpectedly high. Please correct the number of students and applications reported in fields 4-3 A (field 29) and or 4-3 B (field 30). Note: Do not report the same students in both Sections 3 and 4. Medicaid Reduced-Price direct certified student count is reported on the Direct Certification Medicaid Report, not the SFA Verification Report.

T-1 Total FREE Eligible Students Reported
T-2 Total REDUCED PRICE Eligible Students Reported
Total number of approved applications: (This is not on the Verification Report, but it is the number that is used to calculate the sample size for verification in the Standard Method and Alternate Method 1).
Total Applications

Number of Free/Reduced Price Students
Total Enrolled

Section 5
34 (5-1.) All SFAs must report Section 5 or check box 5-1 if applicable.

Check the box if ALL schools and/or RCCIs are exempt from verification (See instructions for list of exemptions).
Instructions
- Schools/RCCIs in which all children have been certified under direct certification procedures including children documented as eligible foster, migrant, runaway or homeless children.
- RCCIs which do not have day students.
- Schools electing the Community Eligibility Option.
- Schools/RCCIs in which FNS has approved universal meal service through census data or using socioeconomic surveys.
  - e.g., special cash assistance claims based on economic statistics regarding per capita income (Puerto Rico and the Virgin Islands).
- Schools participating only in the Special Milk Program.
- Schools in which all children are served with no separate charge for food service and no special cash assistance is claimed, (i.e., non-pricing programs claiming only the paid rate of reimbursement).
- All schools are Provision 2/3 schools in a non base year.
- Schools which do not have any free or reduced price eligible students.
- Other FNS determined exemptions on a case-by-case basis.

"No" is pre-selected when the report is submitted in TX-UNPS. Don't skip this one.
35. (5-2) Was verification performed and completed?

Yes, completed by November 15thYes, completed after November 15thNo, verification was NOT performed or the process was not completed.
36. (5-3) Type of verification process used

Standard (Lesser of 3% or 3,000 error-prone)Alternate one (Lesser of 3% or 3,000 selected randomly)Alternate two (Lesser of 1% or 1,000 error prone applications PLUS lesser of one-half of one percent or 500
37. (5-4) Total ERROR PRONE applications. Report all applications as of October 1st considered error prone.
38. (5-5) Number of Applications selected for verification sample:

Based on the number of applications you entered in Section 4, this is the sample size for the verification method you chose. If there is a discrepancy, check that the number of applications entered was the number of approved applications as of October 1st.
Standard or Alternate 1
Alternate 2
All SFAs must report 5-7 or check box 5-6 if applicable.
39. (5-6) Check the box if direct verification was NOT conducted in the SFA.

(i.e., not one of the schools/and or RCCIS in the SFA performed direct verification
If 5-6 is checked, skip 5-7.
5-7 Confirmed through direct verification: Report if FREE and/or Reduced price eligibility is confirmed through direct verification with SNAP/TANF/FDPIR as of November 15th.

If direct verification was not performed, then check box 5-6 (field 39).

5-7 Confirmed through direct verification:

	40, A. Number of Applications	41. B. Number of Students
5-7

5-8 Results of Verification by Original Benefit Type

For each original benefit type (A, B & C) report the number of applications and students as of November 15th for each category (1, 2, 3, & 4). Do NOT include students and applications already reported in 5-7A or 5-7 B (Direct verification applications and students).

DO include the results of any applications verified for cause.

Results Category

	U - A. FREE - Categorically Eligible a. Applications	V - A. FREE - Categorically Eligible b. Students	W - B. FREE - Income a, Applications	X - B. FREE - Income b. Students	Y - C. REDUCED PRICE - Income a. Applications	Z - C. Reduced Price Students
42 - 1. Responded, NO CHANGE:
43 - 2. Responded, Changed to REDUCED PRICE/FREE:
44 - 3. Responded, Changed to PAID:
45 - 4. NOT Responded, Changed to PAID:

46 (VC-1) Total questionable applications verified for cause:
Report the number of applications as of November 15th verified for cause in addition to the verification requirement.
Number of applications verified
Number of categorically free verified
Number of income free verified
Number of reduced-price verified
Number of students verified

Total Number of Applications to be Verified -- Sample (5-5) and Verified for Cause (VC-1)
Total of applications verified includes Verified for Cause

schools_students_check
10,000
3000
200
Schools/RCCIs
Special Provision check
Should be Empty:

Verification Collection Report

General Information

Instructions:

Section 1 - Total Schools, Residential Child Care Institutions (RCCIs), and Enrolled Students

Section 2 - SFAs with schools operating alternate provisions

Section 3 - Students approved as FREE eligible NOT subject to verification

Section 4 - Students approved as FREE or REDUCED PRICE eligible through a household application

Section 5