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Farm Share Home Fruit Basket
About Food bank soup kitchen
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Farm Share Individual Application
The Emergency Food Assistance Program (TEFAP)

July 1, 2009 - June 30, 2010
5 or 9 digit format
Name of person who can pick up for you if you can not.
The following shows a yearly gross income for each family size. If your houshold income is at or below the income listed for the number of people in your household, you are eligible to receive food. The following chart is effective July 1, 2009 through June 30, 2010.
Household Size Annual Income Monthly Income Weekly Income
1 $14,079 $1,174 $271
2 $18,941 $1,579 $365
3 $23,803 $1,984 $458
4 $28,665 $2,389 $552
5 $33,527 $2,794 $645
6 $38,389 $3,200 $739
7 $43,251 $3,605 $832
8 $48,113 $4,010 $926
For each additional family member add +$4,862 +$406 +$94
You are eligible to receive food from TEFAP if your household meets the income guidelines above or participates in any of the following programs. Please check any category that applies.
Income Eligibility
Food Stamps
Temporary Assistance for Needy Families (TANF)
Supplemental Security Income (SSI), Medicaid
Terms & Conditions
I certify that my yearly houshold gross income is at or below the income listed on this form for housholds with the same number of people OR that I participate in the program(s) that I have checked on this form. I also certify that as of today, I reside in the State of Florida. This certification is being submitted in connection with the receipt of Federal assistance. Program officials may verify what I have certified to be true. I understand that making a false certification may result in having to pay the State agency for the value of the food improperly issued to me and may subject me to civil or criminal prosecution under State and Federal laws.
Date 07/29/2010

This CERTIFICATION IS VALID FOR A PERIOD OF ONE YEAR.

Any changes in the household circumstances must be reported to the distributing agency immediatly.
In accordance with Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability. To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, D.C., 20250-9410 or call (800) 795-3272 (voice) or 202-720-6382 (TTY). USDA is an equal opportunity provider and employer.
         

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Farm Share is located at 14125 SW 320th Street
Homestead, Florida 33033
Phone: (305) 248-3006 Fax: (305) 248-3020