State of California – Health and Human Services Agency | California Department of Social Services EFA 7(7/21)
You self-declare that:
1. Your name and address listed is correct
2. Your household size as stated and resides within this state and organization’s service area
3. Your income is within 235% of the Federal Poverty Guidelines as posted for this distribution
4. You agree that TEFAP food is for home consumption only and will not be sold, traded, or bartered
5. You have read the full USDA Nondiscrimination Statement (external link)
You will not be denied TEFAP food if you refuse to disclose any information that is not a requirement of TEFAP. You will never need to provide your social security number or proof of income.
EFA 7 (7/21) - The Emergency Food Assistance Program (TEFAP) Certification Of Eligibility (external link)
EFA 14 (6/22) - The Emergency Food Assistance Program (TEFAP) 2022 Income Guidelines (external link)
MAXIMUM INCOME /
MÁXIMO DE INGRESOS (June 2022)
HOUSEHOLD SIZE TAMAÑO DEL HOGAR |
MONTHLY HOUSEHOLD INCOME INGRESOS MENSUALES DEL HOGAR |
ANNUAL HOUSEHOLD INCOME INGRESOS ANUALES DEL HOGAR |
1 |
$2,661.38 |
$31,936.50 |
2 |
$3,585.71 |
$43,028.50 |
3 |
$4,510.04 |
$54,120.50 |
4 |
$5,434.38 |
$65,212.50 |
5 |
$6,358.71 |
$76,304.50 |
6 |
$7,283.04 |
$87,396.50 |
7 |
$8,207.38 |
$98,488.50 |
8 |
$9,131.71 |
$109,580.50 |
Over 8 Más de 8 personas |
Add $924.33 each Añada $924.33 por cada persona |
Add $11,092 each Añada $11,092 por cada persona |