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Texas Department of Agriculture - Food and Nutrition Division
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Worksheet to Determine Verification Sample Size
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Verification is to be completed as a Contracting Entity (CE) wide activity by November 15th each year. Households can provide documentation of one month's income for any point in time between the month prior to the application and the time the household is required to provide income documentation.
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1General Information
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CE Name:Rockdale ISD
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CE ID:00812
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Program Year:2021-2022
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Verifying Official:Julie Cortez
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Date direct verification was conducted:
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Date of additional direct verification:
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Date households that were not directly verified were notified of selection:
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Date verification was completed:
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2Enter the total number of approved applications as of October 1st:
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Total applications refers to actual approved application documents/pieces of paper on file October 1. CEs must only complete verification activities based on applications received and certified and must not include directly certified students in their calculations.
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ENTER NUMBER OF APPROVED APPLICATONS:
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Categorically-eligible 0
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Income-based free35
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Income-based reduced-price27
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Total approved applications62
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Number of error-prone applications
(Enter 0 if there are none)		6
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Select the allowable sampling method based on the response rate from the SFA Verification Report from the previous year.
*Check with regional ESC if you don't know		Standard
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Indicate the method you have selected by entering "x" in the box:
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SELECT METHOD OF VERIFICATION:
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Standard
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xCalculated as 3% of total applications. Randomly selected from error-prone applications first.2
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Alternate 1
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Calculated as 3% of total applications. Randomly selected from approved applications.
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Alternate 2
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Calculated as 1% of total approved applications plus 0.5% of Categorically Eligible applications. Randomly select the error-prone and categlorically eligible applications.
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The interval for selecting household applications for verification is determined by dividing the total number of household applications by the sample size.
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3Results of Direct Verification
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For each benefit program, enter the number of applications and students that were directly verified. This information will be reported in the Preliminary Verification Report that opens Nov. 1 and is due Nov. 15.
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A. Number of applicationsB. Number of students
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Directly verified as SNAP
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Directly verified as TANF
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Directly verified as Medicaid Free
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Directly verified as Medicaid Reduced-Price
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Directly verified as CHIP Free
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Directly verified as CHIP Reduced-Price
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TOTAL:
(this will be entered on 5-7 A and B on the SFA Verification Report in TX-UNPS)		00
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4Results of Verification by Original Benefit Type
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Enter the number of applications and students that were verified by household submitted documentation. This information will be reported in the SFA Verification Report (field 5-8) in TX-UNPS that opens December 1st.
Do not include results of direct verification.
Do include the results of any applications verified for cause.
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A. FREE Categorically Eligible a. Applicationsb. Students
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1. Responded, NO CHANGE:
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2. Responded, Changed to REDUCED PRICE:
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3. Responded, Changed to PAID
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4. Not Responded, Changed to PAID
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A. FREE-Income a. Applicationsb. Students
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1. Responded, NO CHANGE:
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2. Responded, Changed to REDUCED PRICE:13
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3. Responded, Changed to PAID12
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4. Not Responded, Changed to PAID
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A. REDUCED PRICE-Income a. Applicationsb. Students
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1. Responded, NO CHANGE:
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2. Responded, Changed to FREE:
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3. Responded, Changed to PAID
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4. Not Responded, Changed to PAID
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VC-1: Total questionable applications verified for cause:
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Update to sample size:
Calculated sample plus applications verified for cause.		2
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Total Applications Verified:ERROR: The number of applications verified does not equal the number of applications in the sample.
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TEXAS DEPARTMENT OF AGRICULTURE
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COMMISSIONER SID MILLERThis institution is an equal opportunity provider.
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