Newport Mesa Unified School District

Online Free and Reduced Application

Letter to Household (Use the scrollbar to view the entire letter) PRINT

Newport-Mesa Unified School District
PRICING LETTER TO HOUSEHOLDS FOR FREE AND REDUCED-PRICE MEALS for the State Meal Program (serves all students)

2017-2018 SCHOOL YEAR

Dear Parent or Guardian:

The Newport-Mesa Unified School District serves breakfast and lunch every school day. Students may buy breakfast for $1.50 at elementary schools, and $2.00 at secondary schools.  The price for lunch is $3.25 at elementary schools and $3.75 at secondary schools. Eligible students may receive reduced breakfast for $.30 and lunch for $.40 or free meals at no cost. Meal applications are to be submitted on line at: http://nmusd.heartlandapps.com. If you do not have access to a computer, applications will be available at school, or phone the Nutrition Service Department at 714.424.5090. All applications will be processed on line.

TERMS—“Household” means a group of related or non-related individuals who are living as one economic unit and sharing living expenses. “Living expenses” include rent, clothes, food, doctor bills, utility bills, etc.

SOCIAL SECURITY NUMBER (SSN)—The Application must include the last four digits of the SSN of the adult who signs it. If the adult does not have a SSN, check the “I do not have a SSN box.” If you have listed a CalFresh, CalWORKs, Kin-GAP, or FDPIR case number for the child, or if the Application is for a foster child, an SSN is not required of the adult signing the Application.

DIRECT CERTIFICATION—This District participates in Direct Certification. If your household currently receives benefits from one of the following programs: CalFresh (previously Food Stamps), California Work Opportunity and Responsibility to Kids (CalWORKs), Kinship Guardianship Assistance Payments (Kin-GAP), or Food Distribution Program on Indian Reservations (FDPIR). DO NOT complete a meal Application. School officials will notify you of your children’s eligibility for free meals. If you are not contacted, but think your children are eligible for free meals, please contact the school cafeteria; you may need to complete an Application.

MIXED HOUSEHOLDS WITH DIRECTLY CERTIFIED, FOSTER, OR/AND NON DIRECTLY CERTIFIED CHILDREN—To apply complete the Application for Free and Reduced-Price Meals. Households must complete an Application when EACH child who does not have a case number or/and is not a foster child.

FDPIR BENEFITS—Households participating in the FDPIR are categorically eligible for free meals/milk. The FDPIR is authorized by Section 4(b) of the Food Stamp Act of 1977. Under this section, eligible households may elect to participate in either the CalFresh Program or the FDPIR. Since households are afforded the option to participate in either program, FDPIR households have been determined to receive the same categorical benefits as CalFresh households.

FOSTER CARE CHILDREN or CHILDREN PLACED IN OUT-OF-HOME CARE— whom are the legal responsibility of a welfare agency or court. Foster children are categorically eligible for free meals without further application, but the eligibility is not extended to other non-foster children in the household. Households with foster/non-foster children are encouraged to complete an Application, since foster children may be counted as a household member, which may help the foster family’s non-foster children qualify for free or reduced-price meals based on the household size and income. If you choose to add both your foster/non-foster children on the Application, you will need to report the foster/ non-foster’s income (personal income provided to the child or earned by the child), if any, and the foster parent signs the Application and provides the last four digits of their SSN.

INCOME HOUSEHOLDS—To apply, complete the Application for Free and Reduced-Price Meals. Follow the instructions on the Application and see the Income to report chart on the right, sign it, and return it to the school. Applications on line: http://nmusd.heartlandapps.com

MILITARY HOUSING INCOME—If you are in the Military Housing Privatization Initiative or get combat pay, DO NOT include these allowances as income. You do report any military benefits received in cash, such as housing allowances (off-base or general commercial/private real estate market), food, clothing, and service member’s income made available by them or on their behalf to the household.

HOMELESS, RUNAWAY, & MIGRANT—For Homeless, Runaway: Contact the school for details.

MEALS FOR DISABLED—If your doctor requires your child to have a special meal/accommodation, please contact Dale Ellis at 714.424.5090.

WIC PARTICIPANTS—If you currently receive benefits under the Special Supplemental Nutrition Program for Women, Infants, and Children (known as WIC), your child may be eligible for free/reduced-price meals. We encourage you to complete an Application http://nmusd.heartlandapps.com

APPLYING FOR BENEFITS—you may apply for meal benefits at any time during the school year. If you are not eligible now, but your income decreases during the school year, you lose your job, your family size becomes larger, or you become eligible for CalFresh, CalWORKs, Kin-GAP, or FDPIR benefits, you may submit an Application at that time.

A COMPLETE HOUSEHOLD APPLICATION—The Application cannot be approved unless it contains complete eligibility information. If you do not enter a CalFresh, CalWORKs, Kin-GAP, or FDPIR case number for each student (or an adult household member) listed on the Application, you must complete the following:
Note: You must complete an Application with all household members and their income listed, for a child who is living with relatives or friends, whether or not the child is a ward of the court.
Section A: The names of all children in your household, name of school or “none” if not in school, their earned income with frequency, or mark the “no income.”
Section B: The names of all adults in the household, the amount of income, the source and frequency of income, or mark the “no income” for each person listed.
Section C: Enter contact information, mailing address, and the last four digits of the SSN of the adult household member signing the Application, or mark the "I do not have an SSN box" if the adult does not have an SSN.

VERIFICATION—School officials may check the information on the Application at any time during the school year. You may be asked to send information to validate your income, or current eligibility for CalFresh, CalWORKs, Kin-GAP, or FDPIR benefits. For a foster child, you will need to provide written documentation that verifies the foster child is the legal responsibility of an agency/court or provide the name and contact information for a person at the agency/court who can verify that the child is a foster child.

OVERT IDENTIFICATION—Children who receive free or reduced-price meals must be treated in the same manner as children who pay full price for meals, and not overtly identified.

FAIR HEARING—If you do not agree with the school's decision regarding your Application’s eligibility determination or the result of verification, you may discuss it with the school. You also have the right to a fair hearing. A fair hearing may be requested by calling or writing the following school official: Dale Ellis at 714.424.5090 or via mail at 2985 Bear Street, Costa Mesa, CA 92626.

INCOME FOR THE SELF-EMPLOYED—Self-employed persons may use last year’s income as a basis to project their current year’s NET income, unless your current net income provides a more accurate measure. The income to be reported is income derived from the business venture less operating costs incurred in the generation of that income. Deductions for personal expenses such as medical expenses and other non-business deductions are not allowed in reducing gross business income.

CALCULATING INCOME—List all adult household members, whether or not they receive income. For each household member with income: write the amount of current income, enter the source of current income received, such as from wages, pensions, retirement, welfare, child support, and so on, for each category, and how often received (frequency). Gross Earnings from work is the amount earned before taxes and other deductions. If any current amount received was more or less than usual, write the usual or projected income. Households receiving different income intervals must annualize their income by calculating weekly x 52; every two weeks x 26; twice a month x 24; and monthly by 12.


Earnings from work before deductions; include all job Gross Wages/salaries/tips, strike benefits, unemployment compensation, workers' compensation, and net income from self-owned business or farm
Pensions Retirement Social Security Pensions, supplemental security income, retirement payments, Social Security Income (SSI) (including SSI a child receives)
Welfare, Child Support, Alimony Public assistance payments, welfare payments, alimony, and child support payments
List Other Income Disability benefits; cash withdrawn from savings; interest and dividends; income from estates, trusts, and investments, regular contributions from persons not living in the household, net royalties and annuities, net rental income, any temporary income

Do you Need Assistance completing the Application or have questions? Please contact: 714.424.5090

You will be notified by the school with a letter when your child’s Application has been approved or denied for free or reduced-price meals.


Dale Ellis
Food Service Director
2985 Bear Street, Costa Mesa, CA 92626

For School Year 2017-2018

Household size Yearly Monthly Weekly
1 $22,311 $1,860 $430
2 $30,044 $2,504 $578
3 $37,777 $3,149 $727
4 $45,510 $3,793 $876
5 $53,243 $4,437 $1,024
6 $60,976 $5,082 $1,173
7 $68,709 $5,726 $1,322
8 $76,442 $6,371 $1,471
For each additional family member, add: $7,733 $645 $149


The Richard B. Russell National School Lunch Act requires the information on this application. You do not have to give the information, but if you do not, we cannot approve your child for free or reduced price meals. You must include the last four digits of the social security number of the adult household member who signs the application. The last four digits of the social security number is not required when you apply on behalf of a foster child or you list a Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) Program or Food Distribution Program on Indian Reservations (FDPIR) case number or other FDPIR identifier for your child or when you indicate that the adult household member signing the application does not have a social security number. We will use your information to determine if your child is eligible for free or reduced price meals, and for administration and enforcement of the lunch and breakfast programs. We MAY share your eligibility information with education, health, and nutrition programs to help them evaluate, fund, or determine benefits for their programs, auditors for program reviews, and law enforcement officials to help them look into violations of program rules.

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

(1) mail: U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410

(2) fax: (202) 690-7442; or

(3) email: program.intake@usda.gov.

This institution is an equal opportunity provider.