WisP - Waiver Request

Appendix J
Waiver Request Online Form

The following steps and screenshots show the data entry screens that a State agency User would see
when requesting a WIC, FMNP or SFMNP Waiver within WiSP. These have been extracted from the draft
WiSP User Guide a of 1/29/2025, and show the fields from the actual screens. Step wording extractedis
the minimum necessary to understand the step, the use guide may contain additional or more detailed
wording.
NOTE: Historically, SFMNP has not had any waivers authorized, however, since WiSP supports all three
Programs the functionality has been built to allow for a potential future SFMNP waiver.

1. SA authorized users will be taken to the WiSP Home screen upon login. On the Home

screen, select the Waiver Requests button to navigate to the Waivers screen.

2. On the Waivers screen, users can select the Create Waiver Request tab to navigate to

the Create Waiver Request form.

3. The WiSP Create Waiver Request form is a multi-screen form. The first screen displays 2

fields and a Category Summary & Citations, which is based upon the selections made in
the two fields. These are the fields and options by Program available to be selected for
the first screen of this form:
a. Which Program are you requesting a waiver for?: WIC, FMNP, or SFMNP (single choice)

b. What Event is the State Agency Experiencing? (WIC or FMNP): Major Disaster
Declaration, Emergency Declaration, Supply Chain Disruption, or Public Health
Emergency (single choice)
c. What Event is the State Agency Experiencing? (SFMNP): Major Disaster Declaration
(single choice)

4. The second screen of the WiSP Create Waiver Request form displays 1 field and a

section that shows a Waiver Summary and Waiver Authority description, which is based
upon the selection made in the field. This is the field and options by Program available
to be selected for the first screen of this form:
a. Which of these best describes the type of wavier the State Agency is requesting? (WIC):
Administrative, Benefits, Certification, Food Package, Infant Formula, Monitoring,
Vendor Management, or Other (single choice)
b. Which of these best describes the type of wavier the State Agency is requesting? (FNMP
or SFMNP): Administrative, Benefits, Certification, Monitoring, Farmer Management,
Coupon/Food Instrument Management, or Other (single choice)

5. The third screen of the WiSP Create Waiver Request form displays 6 fields to be filled in

by the State Agency user:
a. Waiver Title (required): Free text field to identify the waiver. Will be used in list views.
b. Citation (required): Free text field to identify the reason or legal authority for the
waiver.
c. Description (required): Free text field to describe the exact Program elements to be
waived or changed, and what the State agency would like to use instead.
d. Requested Waiver Start Date (required): The date the State agency is requesting for the
waiver to start, entered by typing or via a calendar control button.

e. Requested Waiver End Date (required): The date the State agency is requesting for the
waiver to end, entered by typing or via a calendar control button.
f. Additional Notes (optional): Free text field for adding additional information for FNS
review.

6. The fourth screen of the WiSP Create Waiver Request form displays 1 field and

supporting information and controls to allow the user to upload files in support of the
waiver request. Attaching files is optional, however, if the State agency would like to
attach one or more files there is a field required. Each file must be uploaded
individually. This is the field, options available to be selected, and some notes on this
feature:
a. Attachment Category (required): Data, Correspondence, and Supporting
Information. (single choice)
b. Upload Files button: This will allow the user to search for a file to upload.
c. Or drop files: This area will accept a click and drag drop of a file.
d. NOTE: File formats accepted must be one of the following: *.pdf, *.docx, *.xlsx,
*.zip, *.png, *.gif, or *.jpg.

7. If the State agency uploaded a file, a status window will be displayed letting them know

it was uploaded. This pop-up contains a Done button which would be used by the user:

8. After each attachment, the user is returned to the fourth screen of the WiSP Create

Waiver Request form, where the attached file is listed at the bottom of the screen:

9. The fifth screen of the WiSP Create Waiver Request form displays a list of requirements

that must be confirmed, based upon the waiver type selected. If the waiver type
selected does not require a confirmation, then this screen is skipped:
a. I have read and agree to the confirmation message above.: Checkbox field
indicating a yes/no answer.

10. The sixth and last screen of the WiSP Create Waiver Request form displays a

confirmation message for the user, and allows them to create another request or view
their list of waivers: