Form FNS-844 Report of Disqualification from Participation - Individu

Child and Adult Care Food Program (CACFP) National Disqualified List

Attachment A-2 FNS-844

State Agencies

OMB: 0584-0584

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0584-0584 can be found here:

2023-07-31 - Extension without change of a currently approved collection

Document [pdf]

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Attachment A-2 FNS-844 Report of Disqualification from Participation - Individually
Disqualified Responsible Principal/Individual or Day Care Home Provider

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Introduction
Thisinformation is being colected lo nsisl lhe food Mid Nutrilion SeMCe in ITIMIIMling Ille National Disqu.alitied List of instiulions , day care home prowlers, and ndividuats lhal have been Rmin11ed or olherwise disqu alifiedrrom p.articipation in Ille Ctild
anclMull C¥e food PrO!Jr¥11 (CAC FP). This is a rrwndlllorycolection undeJ Section 2-43(c) of Public Lorized�.�byolherswilbeprosecutedtolhefulleslextenloflhelaw

Attachment A-2
FNS-844- Report of Disqualification from Participation: Individually Disqualified Responsible
Principal/Individual or Day Care Home Provider

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File Modified	2019-11-21
File Created	2019-11-21