Household and Income Form

Dear Parent/Guardian:

Our schools are participating in the Community Eligibility Provision (CEP) under the National School Lunch Program. The CEP provision is available to schools with a high percentage of economically disadvantaged students. Under CEP all students receive a breakfast/lunch at no charge for the entire school year. However, to determine eligibility to receive additional benefits for your child(ren) you will need to complete the Educational Benefits form.

1. Do I need to fill out a FORM for each child?  No. Use one Household and Income Form for all students in your household. We cannot use a form that is incomplete, so be sure to fill out all required information. Return the completed form to: Shirley Baize, Butler County Schools, P O Box 339, Morgantown, KY  42261

2. My CHILD(REN) ALREADY RECEIVE MEALS AT NO CHARGE AT one of the schools.   WHY SHOULD I COMPLETE THIS FORM AS WELL? Many state and federal programs use socioeconomic status (that is, household and income information) to determine eligibility for their programs. In addition, the primary state funding calculation uses socioeconomic status. By completing this form your school is able to determine your child(ren)’s eligibility for additional programs. Regardless, your child(ren) will still receive meals at no charge at the school.

3. Who should I include as members of my household? You must include all people living in your household, related or not (such as grandparents, other relatives, or friends) who share income and expenses. You must include yourself and all children living with you.  If you live with other people who are economically independent (for example, people who you do not support, who do not share income with you or your children, and who pay a pro-rated share of expenses), do not include them.

4. What if my income is not always the same? List the amount that you normally receive. For example, if you normally make $1000 each month, but you missed some work last month and only made $900, put down that you made $1000 per month.  If you normally get overtime, include it, but do not include it if you only work overtime sometimes.  If you have lost a job or had your hours or wages reduced, use your current income.

5. We are in the military. do we include our housing allowance as income? If you get an off-base housing allowance, it must be included as income. However, if your housing is part of the Military Housing Privatization Initiative, do not include your housing allowance as income.

6. My spouse is deployed to a combat zone. is his/her combat pay counted as income?  No, if the combat pay is received in addition to his/her basic pay because of his/her deployment and it wasn’t received before s/he was deployed, combat pay is not counted as income.  Contact your school for more information.

If you have other questions or need help, call 270-526-5624.

Sincerely, 

Kaitlin Harrison, RD, LD

Please click on the form below you wish to complete.  As stated above you only have to complete one form per household, even if your children attend different schools.