To apply for participation in the charitable institution program under 7 CFR Part II, Section 250.67, an applicant shall submit to the surplus distribution section:

1. (a) A fully executed “Agreement For Distribution and Use of USDA Donated Commodities” form containing all information required by 7 CFR Chapter II, 250.12 (b), as described at Adm 612.05 above;
2. (b) A fully executed “Financial Data Form”, as amended 7-20-2023, provided by the surplus distribution section;
3. (c) A fully executed “B-1 Form”, as amended 7-20-2023, provided by the surplus distribution section and appearing on the reverse of financial data form described in (b) above;
4. (d) If licensure, certification, or other approval is required from any governmental entity for the activities conducted by the applicant, such as for bedding capacity or on-site feeding, a copy of the current license, certification, or approval;
5. (e) If the applicant utilizes or is considering utilizing a food service management company as defined in 7 CFR Chapter II, Section 250.3, a food service management company form on which the applicant shall provide the information specified in Adm 612.06(a);
6. (f) If the applicant utilizes a food service management company as defined in 7 CFR Chapter II, Section 250.3, a full copy of a written contract between the applicant and the food services management company;
7. (g) In accordance with 7 CFR, Part II, Section 250.67(a), if the applicant is not a governmental entity, a letter of determination verifying the applicant’s tax-exempt status under the United States Internal Revenue Code; and
8. (h) If the applicant is an adult correctional institution, a written statement signed by an authorized representative of the applicant certifying that the institution conducts rehabilitation programs as described at 7 CFR 250.67(b)(5).

Source. #8310, eff 5-11-05; ss by #10364, eff 7-1-13; ss by #13708, eff 7-29-23 (see Revision Note at chapter heading for Adm 600)