2011 Application & Instructions -...

F R E E A N D R E D U C E D P R I C E S C H O O L M E A L S A P P L I C A T I O N A N D V E R I F I C A T I O N F O R M S

SCHOOL YEAR _____-_____

INSTRUCTIONS FOR SCHOOL DISTRICTS

This packet contains prototype forms:

Required information that must be provided to households: Letter to Households Free and Reduced Price School Meals Application Notice to Households of Approval/Denial of Benefits1 (notification is required if household is denied)

Required information for households selected for verification of eligibility information materials: Notification of Selection for Verification of Eligibility Letter of Verification Results

Optional application-related materials that may be provided to households: Sharing Information with Medicaid/SCHIP Sharing Information with Other Programs Notice to Households of Approval/Denial of Benefits1 (notification is optional if household is approved) Notice of Direct Certification

The pages are designed to be printed on 8½” by 11” paper. Some pages may be printed front and back. You will need to identify the benefits that are offered in your school, such as afterschool snacks. The [bold, bracketed fields] indicate where you need to insert school district specific information. For example, you must include your district’s no-charge telephone number for verification assistance on the verification materials. If these materials have not been modified to include your State’s name for the Supplemental Nutrition Assistance Program (SNAP), formerly the Food Stamp Program, Temporary Assistance to Needy Families (TANF), State Children’s Health Insurance Program (SCHIP), or, if applicable, to add Food Distribution Program on Indian Reservations (FDPIR), you should insert this information as appropriate. This prototype application package includes information regarding the exclusion of housing allowance for those in the Military Housing Privatization Initiative. If this is not pertinent to your school district, please modify as appropriate. Your State agency may require you to submit your application package for approval. If you have questions, contact:

[State agency address]

1All households must be notified of their eligibility status. Households with children who are denied benefits must be given written notification of the denial. The notification must advise the household of the reason for the denial of benefits, the right to appeal, instruction on how to appeal, and a statement that the family may re-apply for free and reduced price meal benefits at any time during the school year. Households with children who are approved for free or reduced price benefits may be notified in writing or orally.

Free and Reduced Price School Meals ApplicationInstructions for School Districts of 1July 2011 - Language

Tongan

[ I N S ER T S C H O OL DI S T R I C T L ET T E RH EA D ]

Ki he Mātu’a/Tauhifānau:

Ke lelei e ako, oku fiema’u ke ma’u me’atokoni fakamo’ui-lelei ‘a e fānau. [Name of School] ‘oku ne ‘oatu e ngaahi me’atokoni fakamo’uilelei faka’aho. Ko e kai-pongipongi ‘oku [$] ; kai ho’ata [$]. ‘Oku lava ‘o kau ho’o fānau kia kinautolu ‘oku nau ma’u e ngaahi me’atokoni ta’etotongi pe totongi holoki. Totongi me’atokoni holoki ‘oku [$] ki he kai pongipongi pea [$] ki he kai ho’atā.

1. TEU FAKAFONU E FOOMU KOLE ‘A E TAMASI’I/TA’AHINE KOTOAPE? ‘Ikai. Fakafonu e tohi-kole ki he me’a-tokoni ta’etotongi pe me’a tokoni hōloki. Faka’aonga’i e foomu tohi-kole pe ‘e taha ‘o e me’atokoni ta’etotongi pe me’atokoni hōloki ki he fānau ako kotoa pe ho ‘api. ‘E ‘ikai te mau tali ha foomu kole ‘oku ‘ikai kakato, koia ai kātaki ‘o fakapapau’i ‘oku ke fakafonu e me’a kotoa ‘oku fiema’u. Fakafoki e foomu ni kuo ‘osi fakafonu kotoa ki he tu’asila ko ena: [name, address, phone number].

2. KO HAI ‘OKU TOTONU KENE MA’U E NGAAHI ME’ATOKONI TA’ETOTONGI? Ko e kotoa ‘o e fānau ‘i he mēmipa-‘api ‘oku nau ma’u penefiti mei he [State SNAP], [the Food Distribution Program on Indian Reservations] pe [State TANF], ‘e lava ke nau ma’u me’atokoni ta’etotongi ‘o ‘ikai fai ha tokanga ki ho’o sino’i pa’anga hu-mai. ‘Ikai koia pe, ‘e lava pe ke ma’u me’atokoni ta’etotongi ho’o fānau kapau ko ho’o sino’i pa’anga hu-mai ‘oku ‘i he līmiti ‘o e Federal Income Eligibility Guidelines.

3. ‘E LAVA PE F NAU PUSIAKI ‘O MA’U ME’ATOKONI TA’E TOTONGI? ‘Io, ko e fānau pūsiaki kotoa ‘oku ‘i he Ᾱmalumalu ‘o e kau fakafofonga faifatongi faka-lao pe fakamaau’anga, ‘oku nau kau/ngofua ki he ngaahi me’atokoni ta’etotongi. Ko ha ki’i tamasi’i/ta’ahine pūsiaki ‘i ha mēmipa-‘api ‘oku ‘i ai ‘ene totonu/ kau/ngofua ki he ma’u me’atokoni ta’etotongi tatau ai pe pe koe ha e fa’ahinga tu’unga fakapa’anga e ‘api koia.

4. ’E LAVA MAU ME’ATOKONII TA’ETOTONI ‘A E F NAUTA’E-HA-‘API, HOLA, PEA MO E F NAU NOFO FONUA-Ᾱ ᾹMAI? ‘Io, ko e fānau ‘oku tuhu-tonu kiai ‘a e fakamatala ‘o e ta’e-ha-‘api, hola, pe nofo-fonua mai ‘oku nau kau he fānau ‘oku nau ma’u me’atokoni ta’etotongi. Kapau ‘oku teeki ke fakaha atu ko ho’o fānau ‘oku tonu ke nau ma’u me’atokoni ta’etotongi, kātaki ‘o telefoni pe ‘i-meili ki he [school, homeless liaison or migrant coordinator information] ke vakai’i pe ‘oku tonu ke nau kau.

5. KO HAI ‘OKU LAVA MA’U E NGAAHI ME’ATOKONI TOTONGI HOLOKI? ’E lava kau ho’o fānau he kalasi ‘oku nau ma’u me’a-tokoni totongi holoki kapau ko ho’o sino’i pa’anga hu-mai faka-‘api‘oku ‘i ha tu’unga holoki ‘o fakatatau ki he totongi fakangatangata ‘a e Federal Eligibility Income Chart, ‘oku fakaha atu he foomu ni.

6. TEU FAKAFONU NAI HA FOOMU TOHI-KOLEKAPAU KUOU ‘OSI MA’U HA TOHI HE TA’U FAKAAKO NI ‘O FAKAHA MAI KUO FAKANGOFUA KE MA’U ME’ATOKONI TA’ETOTONGI ‘EKU FANAU? Kātaki ‘o lau e tohi kuo ke ma’u ke mahino pea muimui ki he ngaahi tu’utu’uni ‘oku fakaha mai. Telefoni ki he ako ‘i he [phone number] kapau ‘oku ‘iai ha ngaahi fehu’i.

7. KO E TOHI-KOLE ‘A ‘EKU TAMA NE ‘OSI TALI HE TA’U KUO ‘OSI. ‘OKU TOE FIEMA’U PE KEU FAKAFONU HA FOOMU ‘E TAHA? ‘Io. Ko e foomu-kole ho’o tama ‘oku ‘aonga pe ki he ta’u faka-ako koia pea mo e ngaahi ‘aho si’i ‘o e konga ki mu’a ‘o e ta’u fakaako koia. Kuo pau ke ke ‘omai ha tohi-kole fo’ou tuku kehe kapau kuo ‘osi fakaha atu ‘e he ‘api ako ‘oku toe hoko atu pe ho’o tama ‘i he ta’u faka-ako fo’ou.

Foomu kole Me’atokoni Fakaako Ta’etotongi mo Totongi HolokiNgaahi tu’utu’uni ki he kolePeesi 1 mei he 2Siulai 2011 - Tongan

8. ‘OKU OU MA’U E WIC. ‘E LAVA PE ‘EKU TAMA/F NAU KE MA’U E NGAAHI ME’ATOKONI TA’ETOTONGI? Ko e Ᾱfānau ‘i he ngaahi ‘api ‘oku kau ki he WIC ‘e lava pe ke kau ki he ngaahi polokalama me’atokoni ta’etotongi pe me’atokoni totongi holoki. Kātaki ‘o fakafonu ha foomu tohi-kole.

9. ‘E FAI HA SIO KE FAKATONUTONU ‘A E FAKAMATALA TEU ‘OATU? ‘Iopea ‘e lava pe ke mau kole atu ke ke ‘omai ha fakamo’oni tohi.

10. KAPAU ‘E ‘IKAI TALI ‘EKU TOHI-KOLE, ‘E LAVA PE KEU TOE KOLE ‘AMUI ANGE? ‘Io, ‘e lava pe ke ‘apalai ‘i ha fa’ahinga taimi lolotonga e ta’u fakaako. Hangē ko eni, ko e fānau ‘a e mātu’a/tauhifānau kuo ‘ikai ha ngāue pea tu’unga vahenga ‘oku to lalo ‘i he tu’unga pa’anga fakangatangata, ko ‘enau fānau ‘e lava pe ke kau ki he polokalama ma’u me’atokoni ta’etotongi mo e me’atokoni totongi holoki.

11. ‘E FĒFĒ, KAPAU ‘E ‘IKAI TEU LOTO KI HE TU’UTU’UNI ‘A E ‘APIAKO KAU KI HE ‘EKU TOHI-KOLE? Kuo pau ke ke talanoa ki he kau ‘ofisa he ‘api ako. Pea ‘e lava pe keke kole ke fai ha fakataha ke fai ha talanoa pe fai ha tohi: [name, address, phone number, e-mail].

12. ’E LAVA PE KEU ‘APALAI KAPAU ‘OKU ‘IAI HA TAHA ‘OKU ‘IKAI KO E U. S. SITISENI ‘I HOKU ‘API? ‘Io. ‘Oku tatau pe koe pe ko ho’o fānau ‘oku ‘ikai fiema’u ia ke ke hoko koe U. S. sitiseni ke ke hu ai ki he polokalama ma’u me’a-tokoni ta’etotongi pe totongi holoki.

13. KO HAI TEU FAKAKAU KO E MEMIPA-’API ‘O’OKU? Teke fakakau ‘a e tokotaha kotoa ‘oku nofo ho ‘api, fāmili pe ta’efāmili (hange ko e kau-mātu’a, fāmili kehe pe kaungāme’a) ‘akinautolu ‘oku fetokoni’aki he fakapa’anga mo e ngaahi fakamole. Kuopau ke ke fakakau koe mo ho’o fānau kotoa ‘oku mou nofo. Kapau ‘oku ke nofo mo e kakai ‘oku tokamālie pe e me’a fakapa’anga (hange ko eni, kakai ‘oku ‘ikai te ke tokoni, kakai ‘oku ‘ikai fai ha fetokoni’aki fakapa’anga mo koe pe ko ho’o fānau, pea mo e fa’ahinga kakai ‘oku nau ‘uluaki totongi ‘a e konga ‘o e ngaahi fakamole), ‘oua na’a fakakau kinautolu.

14. ‘E FEFE KAPAU KO’EKU PA’ANGA HU MAI ‘OKU ‘IKAI TU’UMA’U? Hiki mai e pa’anga ‘oku ke fa’a ma’u. Hange koeni, kapau ko ho’o vahe fakamahina ko e $1000 ‘i he mahina, pea na’e ‘iai e ngaahi ‘aho neke mama’o ai mei he ngāue, pea ko e mahina kuo ‘osi ko e $900 pe, fokotu’u pe ‘a e $1000 he mahina. Kapau ‘oku ke fa’a ngāue ‘ova-taimi, fakakau moia, kae ‘oau na’a fakakau ia kapau ‘oku ke fa’a ngāue ‘ova-taimi he taimi pe ‘e ni’ihi. Kapau kuo mole ho’o ngāue pe kuo fakasi’isi’i ho’o houa ngāue pe vahe, faka’aonga’i/fokotu’u ho’o vahenga lolotonga..

15. ‘OKU OU ‘I HE TAU MALU’I FONUA. TE MAU FAKAKAU MO E PA’ANGA TOKONI FALE KO E PA’ANGA HU-MAI? Kapau teke ma’u ha pa’anga tokoni fale, mei he fale ‘o e Tau Malu’i Fonua ‘i ha feitu’u kehe ‘o ‘ikai ko e Kemi, kuopau ke fakakau ko e pa’anga hu-mai. Kae kehe, kapau ko ho fale ko e konga ‘o e Military Housing Privatization Initiative, ‘oua na’a fakakau e pa’anga tokoni fale ko e pa’anga hu-mai

16. KO HOKU HOA ‘OKU ‘ALU HE TAU. KO HONO VAHENGA ‘ALU HE TAU ‘E KAU IA HE PA’ANGA HU-MAI? ’Ikai, kapau ko ‘ene vahe ‘alu–he-tau ko ha toe vahe tānaki atu pe ki he ‘ene vahe tu’u pau ko e’uhi ko’ene ‘alu he tau, pea na’e ‘ikai ma’u ia kimu’a pea ‘alu he tau, ko e vahe ‘alu–he-tau‘e ‘ikai lau ia ko e pa’anga hu-mai. Ka koha toe fakamatala fetu’utaki ki ho’o ‘apiako.

17. ’OKU FIEMA’U ‘E HOKU F MILI HA TOKONI LAHIANGE. ‘OKU TOE ‘IAI HA NGAAHI POLOKALAMA TE MAU ᾹLAVA KOLE KIAI? Ke fai he fekumi ki ha founga ‘o e ‘apalai ki he [State SNAP] pe ngaahi tokoni penefiti kehe, fetu’utaki ki he ‘ofisi-tokoni fakakolo pe telefoni ki he, [State hotline number].

Kapau ‘oku ‘iai ha’o ngaahi fehu’i pe fiema’u tokoni, telefoni ki he [phone number].

Si necesita ayuda, por favor llame al teléfono: [phone number].

Si vous voudriez d’aide, contactez nous au numero: [phone number].


Faka’apa’apa atu,

[signature]


N G A A H I T U’ UT U’ U NI K I H E K OL E

KO E MEMIPA-‘API KO HA TAMASI’I/TA’AHINE PE TANGATA LAHI/FEFINE LAHI ‘OKU NOFO MO KOE.

KAPAU KO E MĒMIPA-‘API ‘OKU NAU MA’U PENEFITI MEI HE [STATE SNAP], PE [State TANF] [OR THE FOOD DISTRIBUTION PROGRAM ON INDIAN RESERVATIONS (FDPIR)] , MUIMUI KI HE NGAAHI TU’UTU’UNI KO’ENI:

Konga 1: Hiki kotoa ‘a e kau mēmipa ho ‘api pea mo e hingoa ‘o e ‘apiako ki he tamasi’i takitaha. Konga 2: Hiki kotoa e ngaahi fika fakalao ‘a e toko taha mēmipa ho ‘api (kau ai e kakai lalahi) ‘oku nau ma’upenefiti [State SNAP] pe [State TANF] pe [FDPIR]. Konga 3: Li’aki e konga ni. Konga 4: Li’aki e konga ni. Konga 5: Fakamo’oni he foomu. Ko e fo’i fika fakamuimui ‘e fa ‘i he Fika Social Security ‘oku ‘ikailoko fiema’u. Konga 6: Tali e fehu’i ni kapau ‘oku ke fie tali.

KAPAU ‘OKU ‘IKAI HA TAHA HO ‘API ‘OKU NE MA’UPENEFITI [State SNAP] PE [State TANF] PEA KAPAU ‘OKU ‘IAI HA TAMASI’I/TA’AHINE ‘I HO ‘API ‘OKU ‘IKAI-HA-‘API, NOFO-FONUA-MAI PE HOLA, MUIMUI KI HE NGAAHI FAKAHINOHINO KO ENI:

Konga 1: Hiki kotoa ‘a e kau mēmipa ho ‘api pea mo e hingoa ‘o e ‘apiako ki he tamasi’i takitaha. Konga 2: Li’aki e konga ni. Konga 3: Kapau ko e tamasi’i/ta’ahine ‘oku ke ‘apalai kiai ‘oku ‘ikai-ha-‘api, nofo-fonua-mai, pe tamasi’i/ta’ahine hola siofi e puha ‘oku tuha kiai pea fetu’utaki ki he [your school, homeless liaison, migrant coordinator] . Konga 4: Fakakakato kapau ko e tamasi’i/ta’ahine ‘i ho ‘api ‘oku ‘ikai fakangofua ‘ehe Konga 3. Sio ki he ngaahi tu’utu’uni ‘o e ngaahi ‘api kotoa. Konga 5: Fakamo’oni he foomu. Ko e fo’i fika e fa fakamuimui ‘o e Fika Social Security ‘oku ‘ikai loko fiema’u kapau na’e ‘ikai fiema’u keke fakafonu e Konga 4.Konga 6: Tali e fehu’i ni kapau ‘oku ke fie tali.

KAPAU ‘OKU KE ‘APALAI KI HA TAMAPŪSIAKI, MUIMUI KI HE NGAAHI TU’UTU’UNI KO ENI:Kapau ko e kotoa ‘a e fānau ‘i ho ‘api ko e fānau pūsiaki: Konga 1: Hiki kotoa ‘a e fānau pūsiaki mo e hingoa ‘o e ‘apiako ki he tamasi’i takitaha. Fakatokanga’i ‘a e puka ‘oku ne fakaha mai ko e tamasi’i ko e pūsiaki. Konga 2: Li’aki e konga ni. Konga 3: Li’aki e konga ni. Konga 4: Li’aki e konga ni. Konga 5: Fakamo’oni e foomu. Ko e fo’i fika e fa fakamuimui ‘i he Fika Social Security ‘oku ‘ikai loko fiema’u. Konga 6: Tali e fehu’i ni kapau ‘oku ke fie tali.

Kapau ko e ni’ihi ‘o e fānau ‘i ho ‘api ko e fānau pūsiaki: Konga 1: Hiki kotoa ‘a e mēmipa-‘api ho ‘api pea mo e hingoa ‘o e ‘apiako ki he tamasi’i takitaha. Ki ha tahape, kau ai e fānau, ‘ikai ha sino’i pa’anga hu-mai, fakatokanga’i ‘a e puha “No Income “ Fakapapau’i e puha kapau ko e tamasi’i ko e pūsiaki. Konga 2: Kapau ‘oku ‘ikai ha fika fakalao ‘a e ‘api, li’aki e konga ko eni. Konga 3: Kapau ko e tamasi’i ‘oku ke ‘apalai kiai ko e ‘ikai-ha-‘api, nofo-fonua mai, pe hola fakatokanga’i ‘a e puha ‘oku hoa mo ia pea telefoni ki he [your school, homeless liaison, migrant coordinator] . Kapau ‘oku ‘ikai, li’aki e konga ko eni. Konga 4: Muimui ki he ngaahi fakamatala ni ke lipooti ‘a e sino’i pa’anga hu-mai ki he mahina ni mo e mahina kuo hili.

Puha 1–Hingoa: Lisi ‘o e mēmipa-‘api kotoa ‘oku ‘iai ‘enau pa’anga hu-mai.

Foomu kole Me’atokoni Fakaako Ta’etotongi mo Totongi HolokiTu’utu’uni ki he Foomu kole Peesi 1 mei he 2Siulai 2011 - Tongan

Puha 2 –Sino’i Pa’anga hu-mai kakato pea mo e founga honoma’u: Ki he tokotaha kotoa ‘i he mēmipa-‘api, lisi mai ‘a e fa’ahinga kalasi ‘o e pa’anga hu-mai ‘oku ma’u ‘i he mahina. Kuopau ke ke fakaha mai ‘oku ‘omai/ha’u tu’o fiha e pa’anga ni – faka-uike, faka-uike ua, tu’o ua he mahina pe fakamahina. Ki he ngaahi pa’anga-vahe ma’u mai, fakapapau’i ke lisi mai vahenga kakato, ‘ikai ko e pa’anga ‘oku ke ‘alu mo’ia ki ‘api. Ko e vahenga kakato ko e sino’i pa’anga ‘oku ma’u mei he ngāue ki mu’a e to’o e ngaahi tukuhau mo e ngaahi to’o kehe. ‘E lava pe keke ‘ilo eni he pepa-vahe pe ‘e fakaha atu ‘e ho’o pule-ngāue. Ko e ngaahi pa’anga hu-mai kehe, lisi mai ‘a e sino’i pa’anga ‘a e toko taha ‘oku ma’u fakamahina mei he uolefea, pa’anga tokoni ki he fānau, pa’anga huhu’i, penisoni, pa’anga mālōlō mei he ngāue, Social Security, (Malu’i Fakafonua) Supplemental Security Income (SSI), (Pa’anga Tokoni mei Potungāue Malu’i) Veteran’s benefits (VA benefits), (Penefiti ‘a e Matu’a kuo mālōlō mei he ngāue/tau) pea mo epenefiti mahaki’ia fakasino. ‘I he malumalu ‘o e Kotoa ‘o e Pa’anga Hu-mai Kehe, lisi mai Worker’s Compensation, (Pa’anga huhu’i ‘a e kau Ngāue) ta’e ma’ungāue, pe penefiti tuku-ngāue, ko e ngaahi tokoni faka-pa’anga ‘a e kakai ‘ikai nofo ho ‘api, pea mo ha toe pa’anga hu-mai kehe. ‘Oua e fakakau ‘a e ‘inikami mei he SNAP, FDPIR, WIC, Ko e penefiti mei he Potungāue- Ako Faka-pule’angapea mo e ngaahi totongi pa’anga pūsiaki ‘a e ngaahi fāmili ne tokanga’i ‘e he ngaahi fakafofonga-ngāue’anga. Ko e TAAFATAHA PE ki he tokotaha ngāue-ma’ana, ‘i he malumalu ‘o e ngaahi Ma’u’anga Pa’anga mei he Ngāue, lipooti ‘o e pa’anga hu-mai hili e ngaahi fakamole. Ko e me’a eni ki ho’o pisinisi, faama, pe ‘api nofo totongi. Kapau ‘oku ke ‘ihe Kau Tau Malu’i Fonua Privatized Housing Initiativepema’u vahenga mei he ‘alu he tau, ‘oua na’a fakakau e ngaahi vahenga ni ‘i he pa’anga hu-mai.

Konga 5: Ko e kakai lalahi kuopau ke nau fakamo’oni ‘i he foomu pea lisi mai ‘a e mata’i fika e fa fakamuimui ‘o ‘enau Fika Social Security (pe faka’ilonga’i ‘a e puha kapau ‘oku ‘ikai ha fika). Konga 6: Tali e fehu’i ni, kapau teke fili.

KO E KOTOA ‘O E ME’A FAKA’API, KAU AI E WIC FAKA’API, MUIMUI KI HE NGAAHI TU’UTU’UNI: Konga 1: Hiki kotoa ‘a e mēmipa-‘api pea mo e hingoa ‘o e ‘apiako ki he tamasi’i takitaha. Pea ki ha taha pe, kau heni e fānau, ‘ikai ha pa’anga hu-mai, fakatokanga’i ange ‘a e puha “No Income”.Konga 2: Kapau ko e mēmipa-‘api ‘oku ‘ikai ha fika fakalao, liaki e konga ni. Konga 3: Kapau ko e tamasi’i ‘oku ke ‘apalai kiai ‘oku hala mo e ‘api, nofo-fonua mai, pe hola tokanga ke siofi ‘a e puha ‘oku tuha pea telefoni ki he [your school, homeless liaison, migrant coordinator] . Kapau ‘oku ‘ikai, li’aki e konga ni. Konga 4: Muimui ki he ngaahi tu’utu’uni ke lipooti ‘a e kotoa ‘o e sino’i pa’anga hu-mai ‘a e ‘api ni ki he mahina ni mo e mahina

kuo hili. Puha1–Hingoa: Lisi kotoa ‘a e mēmipa-‘api ‘oku ‘i ai ‘enau pa’anga hu-mai. Puha 2 – Sino’i Pa’anga hu-mai kakato pea mo e founga honoma’u: Ki he tokotaha kotoa ‘i he memipa-‘api, lisi mai ‘a

e fa’ahinga kalasi ‘o e pa’anga hu-mai ‘oku ma’u ‘i he mahina. Kuo pau ke ke fakaha mai ‘oku ‘omai/ha’u tu’o fiha e pa’anga ni – faka-uike, faka-uike ua, tu’o ua he mahina pe fakamahina. Ki he ngaahi pa’anga-vahe ma’u mai, fakapapau’i ke lisi mai vahenga kakato, ‘ikai ko e pa’anga ‘oku ke ‘alu mo’ia ki ‘api. Ko e vahenga kakato ko e sino’i pa’anga ‘oku ma’u mei he ngaue ki mu’a e to’o e ngaahi tukuhau mo e ngaahi to’o kehe. ‘E lava pe keke ‘ilo eni he pepa-vahe pe ‘e fakaha atu ‘e ho’o pule-ngāue. Ko e ngaahi pa’anga hu-mai kehe, lisi mai ‘a e sino’i pa’anga ‘a e toko taha ‘oku ma’u fakamahina mei he uelefea, pa’anga tokoni ki he fānau, pa’anga huhu’i, penisoni, pa’anga mālōlō mei he ngāue, Social Security, Supplemental Security Income (SSI), Veteran’s benefits (VA benefits), pea mo e penefiti mahaki’ia fakasino. ‘I he malumalu ‘o e Kotoa ‘o e Pa’anga Hu-mai Kehe, lisi mai Worker’s Compensation, ta’e ma’ungāue, pe penefiti tuku-ngāue, ko e ngaahi tokoni faka-pa’anga ‘a e kakai ‘ikai nofo ho ‘api, pea mo ha toe pa’anga hu-mai kehe. ‘Oua e fakakau ‘a e ‘inikami mei he SNAP, FDPIR, WIC, Ko e penefiti mei he Federal education pea mo e ngaahi totongi pa’anga pūsiaki ‘a e ngaahi fāmili ne tokanga’i ‘e he ngaahi fakafofonga-ngāue’anga. Ko e TAAFATAHA PE ki he tokotaha ngāue-ma’ana, ‘i he malumalu ‘o e ngaahi Ma’u’anga Pa’anga mei he Ngāue, lipooti ‘o e pa’anga hu-mai hili e ngaahi fakamole. Ko e me’a eni ki ho’o pisinisi, faama, pe ‘api nofo totongi. Kapau ‘oku ke ‘ihe Kau Tau Malu’i Fonua Privatized Housing Initiative pe ma’u vahenga mei he ‘alu he tau, ‘oua na’a fakakau e ngaahi vahenga ni ‘i he pa’anga hu-mai.

Konga 5: Ko e kakai lalahi mēmipa-‘api kuopau ke nau fakamo’oni he foomu pea hiki ‘a e mata’i fika ‘e fa fakamuimui ‘o e Fika Social Security (pe maaki’i ‘a e puha kapau ‘oku ‘ikai ha fika).

Konga 6: Tali, ‘a e fehu’i ni kapau ko ho’o fili ia.

Foomu kole Me’atokoni Fakaako Ta’etotongi mo Totongi HolokiTu’utu’uni ki he Foomu kole Peesi 2 mei he 2Siulai 2011 - Tongan

KO E FOOMUKOLE ME’ATOKONI FAKAF MILI FAKAAKOKI HEᾹ NGAAHI ME’ATOKONI TA’ETOTONGI PEA MO E ME’ATOKONI

TOTONGI HOLOKI

KONGA 1. KO E KOTOA ‘O E MĒMIPA-‘API

Ngaahi hingoa kotoa ‘o e mēmipa-‘api (hingoa ‘uluaki, ‘uluaki mata’itohi ‘o e hingoa ua, hingoa faka’osi)

Hingoa ‘o e ako ki he tamasi’i taki taha/pe faka’ilonga’i “NA “ kapau ‘oku ‘ikai ako e tamasi’i

Fakapapau’i kapau ko e tamasi’i pūsiaki (malumalu fakalao ‘o e fakafofonga Uelofea pe fakamaau’anga)

* Kapau ko e kotoa ‘o e fānau ‘oku lisi atu ‘i lalo ko e fānau pūsiaki, ‘alu ki he Konga 5 ke fakamo’oni he foomu ni.

Siofi kapau ‘oku ‘IKAI ha sino’i pa’anga hu-mai

Konga 2. NGAAHI PENEFITI

KAPAU ‘OKU ‘I AI HA MĒMIPA-‘API ‘OKU NE MA’U [State SNAP], [FDPIR] PE [State TANF Cash Assistance], TOKONAKI MAI ‘A E HINGOA PEA MO E FIKA FAKALAO ‘A E TOKO TAHA MA’U E NGAAHI PENEFITI PEA ‘ALU KI HE KONGA 5. KAPAU ‘OKU ‘IKAI HA TAHA ‘E MA’U E NGAAHIPENEFITI, ‘ALU KI HE KONGA 3.

HINGOA: __ ____________________FIKA FAKALAO: ______________________________________________________________________________________

KONGA 3. KAPAU ‘OKU ‘I AI HA TAMASI’I ‘OKU KE KOLE ‘OKU ‘IKAI-HA-‘API, NOFO-FONUA MAI, PE HOLA TOKANGA PAU KI HE PUHA ‘OKU HOA MO E TOKOTAHA NI PEA TELEFONI [your school, homeless liaison, migrant coordinator at phone #] ‘IKAI-HA-‘API NOFO-FONUA MAI HOLA

KONGA 4. KOTOA ‘A E SINO’I PA’ANGA HU-MAI HO ‘API. Kuopau ke ke fakaha mai hono lahi pea ‘oku tu’o fiha ‘ene ha’u/ma’u.

1. HINGOA Lisi pe ‘a e mēmipa-‘api ‘oku ‘i ai ‘ene pa’anga hu-mai)

2. PA’ANGA FAKAKATOA TEEKI TO’O TUKUHAU PEA ‘OKU TU’O FIHA ‘ENE MA’U

Vahenga mei he ngāue kimu’a e ngaahi to’o

Uelafea, pa’anga totongi tamasi’i, child support,

pa’anga huhu’i

Penisoni, mālōlō mei he ngāue, Social Security,

SSI, VA penefits

Ko e kotoa ‘o e pa’anga hu-mai kehe

(Fakatātā) Seini Simifi$199. 99/ fakauike $149. 99/ fakauike ua $99. 99/ fakamahina $50. 00/fakamahina$______/___________________ $______/___________________ $______/___________________ $______/___________________

$______/___________________ $______/___________________ $______/___________________ $______/___________________

$______/___________________ $______/___________________ $______/___________________ $______/___________________

$______/___________________ $______/___________________ $______/___________________ $______/___________________

$______/___________________ $______/___________________ $______/___________________ $______/___________________

$______/___________________ $______/___________________ $______/___________________ $______/___________________

Foomu kole Me’atokoni Fakaako Ta’etotongi mo Totongi HolokiFoomu KolePeesi 1 mei he 3Siulai 2011 - Tongan

KONGA 5. FAKAMO’ONI PEA MO E FO’I FIKA ‘E FA FAKAMUIMUIM ’O E FIKA SOCIAL SECURITY (KUOPAU KE FAKAMO’ONI E KAKAI LALAHI)

Kuo pau ke fakamo’oni ha toko taha lahi ‘o e memipa-‘api ‘i he foomu kole. Kapau ko e Konga 4 kuo kakato, ko e toko taha lahi na’e fakamo’oni he foomu pea ke hiki e mata’i ‘e fa fakamuimui ‘o ‘ene Fika Sosial Security pe maaka’i ‘a e puha “Oku ‘ikai ha’aku Fika Social Security“. (Sio ki he fakamatala ‘i he tu’a ‘o e peesi ni.)

‘Oku ou fakamo’oni (palōmesi) ko e kotoa ‘o e fakamatala ‘i he tohi kole ni ‘oku mo’oni pea ko e kotoa ‘o e pa’anga hu-mai ‘oku lipooti ‘Oku mahino lelei kia au ‘e ma’u ‘e he ‘apiako ‘a e pa’anga pau mei he fakapa’anga ‘a e Federal ‘o makatu’unga he ngaahi fakamatala ‘oku ou ‘atu. ‘Oku mahino kia au ko e kau ‘ofisa mei he ‘apiako te nau fakamo’oni’i (sieke) ‘a e fakamatala. ‘Oku mahino kia au kapau te u ‘oatu ha fakamatala hala ‘ilo’ilopau, ‘e mole e ngaahi penefiti me’atokoni ‘a e fānau, pea ‘e lava pe ke faka’ilo au.

Fakamo’oni heni: ____________________________________________________________ Tohi ho hingoa:

‘Aho:

Tu’asila: ______________________________________________________________________ Fika Telefoni:

Kolo lahi: _____________________________________________________________________ Fonua: ____________________________ Zip Code:

Fo’i fika e fa fakamuimui ‘o e Social Security: * * * - * * - ___ ___ ___ ___ ‘ikai ha Fika Sosial Security

KONGA 6. KO E MATAKALI PE FA’AHINGA KAKAI/LANU ‘OKU KAU KI AI E FĀNAU (FA’ITELIHA PE)

Fili e matakali ‘e taha: Fili e taha pe lahi hake (‘oua e tokanga ki he faka-matakali) :

Matakali-Sepeni/Latina

‘IkaiMatakali-Sepeni/Latina

‘Esia Initia Amelika pe Kakai ‘Alāsaka ‘Amelika ‘Uli’uli pe ‘Afilika

Pālangi Kakai Hawaiipetaha mei ‘otu motu Pasifiki

‘OUA E FAKAFONU ‘A E KONGA KO ENI. KO E KONGA ENI KI HE ‘APIAKO PE.

Liliu ‘o e Pa’anga hu-mai Fakata’u: Fakauike x 52, Fakauike-ua x 26, Tu’o ua he māhina x 24 Fakamāhina x 12

Katoa Pa’anga hu-mai: ____________ Faka: Uike, Uike ua, Tu’o ua he mahina, Mahina kotoa, Ta’u Lahi ‘o e ‘api: ________

Fili’i ‘o e Ngofua: ___ ‘Aho tuku ai: ________Ngofua: Ta’e totongi___ Holoki___ Fakafisinga___

‘Uhinga: __________________________________________________________________________________________________________________________

Fakataimi: Ta’e totongi _____ Holoki _____ Lahi e Taimi: ___________ (‘osi hili _____ ‘aho)

Fakamo’oni ‘a e ‘Ofisa Fili: ______________________________ ‘Aho: ______________

Fakapapau’i Fakamo’oni ‘a e ‘Ofisa: _________________ ‘Aho: ___________

Fakamo’oni’i Fakamo’oni ‘a e ‘Ofisa: _______________’Aho: ________


‘E lava ho’o fānau ‘o ma’u me’atokoni ta’etotongi pe totongi holoki kapau ko e ‘Inikami mei ho ‘api ‘oku to tonu he levolo fakangatangata pe ki lalo he levolo fakangatangata ‘o e siate.

Ko e konga lao mei he Richard B. Russell National School Lunch Act (Lao Fakafonua kau ki he Me’atokoni Ho’ata Fakaako) ‘oku ne fiema’u ‘a e fakamatala ‘i he tohi kole ni. ‘Oku ke fa’iteliha pe pe teke ‘omai e fakamatala, pea kapau ‘e ‘ikai teke ‘omai, ‘e ‘ikai te mau fakangofua ho’o tama ki he me’atokoni ta’etotongi pe me’atokoni totongi holoki. Kuopau ke ke fakakau ‘a e fo’i fika faka’osi ‘e fa ‘o e fika social security ‘o e tokotaha lahi memipa-‘api ‘oku fakamo’oni ‘i he tohi kole ni. Kuo pau ke ke fakakau ‘a e fo’i fika e fa fakamuimui‘o e fika social security ‘oku ‘ikai fiema’u ‘i ho’o ‘apalai ko e’uhi ko ha tamasi’i pusiaki pe ‘oku ke lisi ‘i ha Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance ma’ae Needy Families (TANF) Program pe or Food Distribution Program ‘i he Indian Reservations (FDPIR) fika fakalao pe toe FDPIR faka’ilonga ma’a ho’o tama pe ‘i ho’o faka’ilonga’i ko e toko taha lahi māmipa-‘api na’e fakamo’oni he tohi kole ‘oku ‘ikai ha ‘ane fika social security. Ko e fo’i fika fakamuimui ‘e fa ‘o e social security ‘oku ‘ikai fiema’u ‘i ho’o ‘apalai fakafofonga’i ha tamasi’i pusiaki pe ‘oku ke lisi ‘i he Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance ma’ae Needy Families (TANF) Program pe Food Distribution Program ‘i he Indian Reservations (FDPIR) fika fakalao peme’a makehe FDPIR faka’ilonga’i ki ho’o tama pe ‘i ho’o faka’ilonga’i ko e toko taha lahi memipa-‘api na’e fakamo’oni he tohi kole ‘oku ‘ikai ha ‘ane fika social security. Te mau faka’aonga’i ho’o fakamatala ke fakapapau’i ko ho’o tama ngofua ki he me’atokoni ta’etotongi pe me’atokoni totongi holo, pea ki hono pule’i mo fakamālohi’i ‘o e ngaahi polokalama kai ho’ata mo e kai pongipongi. ‘E LAVA pe ke mau tufotufa atu ‘a e ngaahi fakamatala-ngofua potungāue ako, mo’ui pea mo e polokalama ‘a e me’atokoni faka-mo’ui lelei ke tokoni ki hono fakamahu’inga’i, fakapa’anga’i, pe fakapapau’i ‘a e lelei ‘o ‘enau ngaahi polokalama, ki he kau faka’atita ki hono siofi ‘o e polokalama, pea ki he kau ‘ofisa lao ki hono siofi ‘o e tauhi ‘o e ngaahi tu’utu’uni ‘o e polokalama.

Fakamatala Ta’e-filifilimānako: ‘Oku fakamatala heni ‘a e me’a teke fai kapau ‘oku ke tui ‘oku ‘i ai ‘a e filifilimānako ‘i ho’o mou fekau’aki “ ‘I he fakatatau mo e Lao Federal pea mo e founga ngāue ‘a e Potungāue Ngoue ‘a U. S. , ko e potungāue ni ‘oku tapu’i mei he filifilimānako ‘o makatu’unga he matakali, lanu, tupu’i, fonua, tangata pe fefine, pe mahaki’ia fakasino. Ke fai ha launga tu’unga he filifilimānako, tohi ki he USDA, Director, Office of Adjudication, 1400 Independence Avenue, SW, Washington, D. C. 20250-9410 pe telefoni ta’etotongi (866) 632-9992 (Le’o). Ko kinautolu ‘oku ‘ikai lelei e fanongo pe ‘ikai lelei e lea ‘e lava fetu’utaki ki he USDA fakafou atu he Federal Relay Service (Kautaha Tokoni Fakakomoniueli) ‘i he (800) 877-8339; pe (800) 845-6136 (Sepeni). USDA ko e potungāue ‘oku nau taukave’i ‘a e faingāmalie tatau ki he kautaha mo e ngāue’anga.”


KO E SIATE NGOFUA MEI HE FEDERAL KI HE Ta’u Fakaako________

Lahi ‘o e ‘Api Fakata’u Fakamāhina Fakauike

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Ko ha tokotaha tānaki mai:

VAHEVAHE ATU E FAKAMATALA KI HE MEDICAID/SCHIP

Ki he Mātu’a/Tauhi-fānau:

Kapau ‘oku ma’u me’atokoni ta’etotongi pe me’atokoni totongi holoki, ‘e lava pe ke ma’u foki ‘a e ‘Inisiua mo’uilelei mei he Polokalama Medicaid pe the State Children's Health Insurance (Kautaha ‘Inisiua ‘a e Pule’anga ki heMo’uilelei ‘a e Fānau) (SCHIP). ta’etotongi pe totongi ma’ulalo. Ko e fānau ‘oku ‘i ai ‘enau ‘Inisiua mo’uilelei ‘oku hangehange pe te nau ma’u tokoni mo’uilelei hokohoko pea ‘o si’i ‘enau liaki ako ko e’uhi ko e puke.

Koe’uhi ko e mahu’inga ‘a e ‘inisiua mo’uilelei ki he tupu ‘a e fānau, ‘oku fakangofua ai ‘e he lao kimautolu ke mau fakahoko ki he Medicaid and SCHIP ko ho’o fānau ‘oku ‘i ai e ngofua ki he me’atokoni ta’etotongi pe me’atokoni totongi holoki, tuku kehe kapau te ke fakaha mai ke tuku. Ko e Medicaid mo e SCHIP ‘oku nau faka’aonga’i pe ‘a e fakamatala ke faka’ilonga’i ‘a e fānau ‘e lava pe ‘o kau ki he ‘enau ngaahi polokalama. ‘E lava pe ‘e he kau ‘ofisa polokalama ‘o fetu’utaki atu kia koe ke lēsisita ho’o fānau. Ko hono fakafonu ‘o e tohi kole ki he me’a tokoni ta’etotongi pea mo e me’atokoni totongi holoki fakaako ‘oku ‘ikai ‘otomētiki ho’o fānau ke lēsisita ‘i he ‘inisiua mo’uilelei.

Kapau ‘oku ‘ikai te ke loto ke mau ‘oatu ho’o fakamatala ki he Medicaid pe SCHIP, fakafonu e foomu ‘i lalo pea ‘omai. (Ko ho’o ‘omai e foomu’e ‘ikai liliu ai e ma’u me’atokoni ta’etotongi pe ma’u me’atokoni totongi holoki ho’o fānau.)

‘Ikai! ‘OKU ‘IKAI TE U LOTO ke ‘ave e fakamatala mei he foomu kole tokoni fakaako me’atokoni ta’etotongi pea mo e me’atokoni totongi holoki ki he Medicaid pe ko e Polokalama State Children's Health Insurance.

Kapau ‘oku ke pehe ‘ikai, fakafonu e foomu ‘i lalo ke fakapapau’i ko ho’o fakamatala ‘e ‘IKAI vahevahe atu ki he fānau ‘oku lisi ‘i lalo:

Hingoa e tama: ___________________________________________’Apiako: ______________________________________________________



Hingoa e tama: ___________________________________________’Akpiao: ______________________________________________________

Fakamo’oni ‘a e Matu’a/Tauhi-fanau: ________________________________________________________’Aho: ___________________

Tohi’i e hingoa: __________________________________________________________________________________________________________

Tu’asila: __________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________________

Ka koha toe fakamatala, ‘e lava pe keke telefoni, [name] ‘i he [phone] pe ‘i-meili‘i he [e-mail address].

Fakafoki e foomu ni ki: [address] ‘i he [date].

Foomu kole Me’atokoni Fakaako Ta’etotongi mo Totongi HolokiVahevahe atu e fakamatala ki he Medicaid/SCHIP Peesi 1 mei he 1Siulai 2011 - Tongan

VAHEVAHE ATU E FAKAMATALA KI HE NGAAHI POLOKALAMA KEHE


Ke fakanounou ho taimi mo e ngāue, ko e fakamatala na’ake ‘omai ‘i ho’o foomu kole me’atokoni fakaako ki he me’atokoni ta’etotongi pea mo e me’atokoni totongi holoki ‘e lava pe ke vahe atu ki he ngaahi polokalama kehe ‘e lava kau kiai ho’o fānau. Ko e ngaahi polokalama ko eni, ‘oku fiema’u ke ma’u ha ngofua meia koe ke vahevahe atu e fakamatala. Ko hono ‘omai e foomu ni ‘e ‘ikai liliu ai pe ‘oku kau ho’o fānau pe ‘ikai ki he ma’u me’atokoni ta’etotongi pe ma’u me’atokoni totongi holoki.

‘Io! ‘Oku ou loto lelei ki he kau ‘ofisa ako ke nau vahevahe atu ‘a e ngaahi fakamatala mei ‘eku foomu kole me’atokoni faka-ako ta’etotongi pea mo e me’atokoni totongi holoki mo e [name of program specific to your school].

‘Io! ‘Oku ou loto lelei ki he kau ‘ofisa ako ke nau vahevahe atu ‘a e ngaahi fakamatala mei ‘eku foomu kole me’atokoni faka-ako ta’etotongi pea mo e me’atokoni totongi holoki mo [name of program specific to your school].

‘Io! ‘Oku ou loto lelei ki he kau ‘ofisa ako ke nau vahevahe atu ‘a e ngaahi fakamatala mei ‘eku foomu kole me’atokoni faka-ako ta’etotongi pea mo e me’atokoni totongi holoki mo [name of program specific to your school].

Kapau na’a ke tali ‘io ki ha taha pe kotoa ‘o e ngaahi puha ‘i ‘olunga, fakafonu e foomu ‘i lalo ke fakapapau’i ko ho’o fakamatala ‘e vahe atu ki he tama/tamaiki ‘oku lisi atu ‘i lalo. Ko ho’o fakamatala ‘e vahe atu pe ki he ngaahi polokalama kuo ke loto kiai.

Hingoa eTama: ___________________________________________’Apiako: ______________________________________________________




Fakamo’oni e Mātu’a/Tauhi-fānau: ________________________________________________________’Aho: _____________________

Tohi ho Hingoa:__________________________________________________________________________________________________________

Tu’asila:___________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________________

Ka koha toe fakamatala, telefoni koe kia [name] ‘i he [phone] pe ‘i-meili‘i he [e-mail address].

Foomu kole Me’atokoni Fakaako Ta’etotongi mo Totongi HolokiVahevahe atu e Fakamatala ki he ngaahi polokalama kehe Peesi 1 mei he 1Siulai 2011 - Tongan

Fakafoki e foomu ki he: [address] ‘i he [date].

Foomu kole Me’atokoni Fakaako Ta’etotongi mo Totongi HolokiVahevahe atu e Fakamatala ki he ngaahi polokalama kehe Peesi 1 mei he 1Siulai 2011 - Tongan

TE MAU TOE SIO KI HO’O TOHI KOLE

Kuo pau ke ke ‘omai e fakamatala ‘oku mau fiema’u, pe fetu’utaki [name] ‘i he [date], pe ko ho’o tama/fānau ‘e ta’ofi ‘enau ma’u e ngaahi me’atokoni ta’etotongi pe me’atokoni totongi holoki.

‘Apiako: _______________________________________________________________________________ ‘Aho: ______________________

Kia _________________________________________________:

‘Oku mau toe sio ki ho’o Tohi-Kole Me’akai Fakaako Ta’etotongi pea mo e Me’atokoni Totongi Holoki. Ko e ngaahi tu’utu’uni ‘ia ‘a e Federal ‘oku fiema’u ke mau fai eni ke fakapapau’i ko e fānau pe ‘oku fakangofua ‘oku nau ma’u e me’atokoni fakaako ta’etotongi pe me’atokoni totongi holoki. Kuo pau ke ke ‘omai e fakamatala ke fakamo’oni’i ko e [name(s) of child(ren)] kou fakangofua.

Kapau ‘e lava, ‘omai e ngaahi tatau, ‘ikai ko e ‘uluaki tatau-pepa. Kapau teke ‘omai e ‘uluaki tatau-pepa, ‘e toe fakafoki atu kiate koe ‘o kapau teke fiema’u.

1. KAPAU ‘OKU KE MA’U PENEFITI MEI HE [State SNAP], [State TANF] PE [FDPIR] KAPAU NA’A KE TOHI KOLE KI HEME’ATOKONI TA’ETOTONGI PE ME’ATOKONI TOTONGI HOLOKI PE ‘I HA TAIMI PE HILI ENI, ‘OMAI HA TAHA ‘O E NGAAHI TATAU ‘O E TAHA ‘O E NGAAHI TOHI KOLE:

[State SNAP] pe [State TANF] pe [FDPIR] TohiFakamo’oni ‘oku ne fakaha ‘a e ngaahi ‘aho ‘o e fakamo’oni.

Tohi mei he [State SNAP] pe [State TANF] pe [FDPIR] ‘ofisi ‘oku ne fakaha ‘a e ngaahi ‘aho ‘o e fakamo’oni.

‘Oua na’a ‘omai ho’o kaati EBT.

2. KAPAU TEKE MA’U E TOHI NI KAU KI HA TAHA TA’E-HA-‘API, NOFO-FONUA MAI, PE TOKOTAHA HOLA, K TAKI ‘O FETU’UTAKI Ᾱ [school, homeless liaison, or migrant coordinator] KE TOKONI’I.

3. KAPAU KO E TAMA KO E TOKOTAHA P SIAKIῡ : ‘Omai ha fakamatala tohi ke fakamo’oni’i ko e tamasi’i ‘oku ‘i he malumalu ‘o e fakafofonga fakalao pe fakamaau’anga pe ‘omai ‘a e hingoa mo e fakamatala fetu’utaki ‘o ha tokotaha he kautaha fakafofonga pe fakamaau’anga ‘e lava ‘o fakapapau’i ko e tamasi’i ko e tama pusiaki.

4. KAPAU ‘OKU ‘IKAI HA TAHA ‘I HO MEMIPA-‘API ‘OKU NE MA’U [State SNAP] pe [State TANF] pe [FDPIR] penefiti: ‘Omai ‘a e peesi ni fakataha mo e ngaahi pepa ‘oku nau fakaha ‘a e sino’i pa’anga ‘oku ma’u mei he ngaahi tafenga pa’anga taki taha. Ko e ngaahi pepa teke ‘omai kuo pau kene fakaha ‘a e hingoa ‘o e tokotaha ‘oku ‘a’ana ‘a e pa’anga hu-mai, ko e ‘aho na’e ma’u ai, ko e lahi e pa’anga ne ma’u, pea na’e tu’o fiha ‘ene ma’u. ‘Ave e fakamatala ki he: [address]

Ngaahi pepa ‘e tali-lelei ‘e kau ai:

NGAAHI NGAUE’ANGA: Ko e la’i pepa vahe pe sila vahe ‘oku ‘asi ai e katoa e vahe pea ‘oku tu’o fiha ‘ene ma’u; tohi mei he pule-ngāue ‘oku ‘asi ai e kotoa e vahe pea ‘oku tu’o fiha ho’o vahe; pe, kapau ‘oku ke ngāue ma’au, pisinisi pe ngaahi pepa/tohi ‘a e faama, hange ko e ledger pe ngaahi tohi tukuhau.

SOCIAL SECURITY, PENISONI, PE M LŌLŌ MEI HE NG UE: Ᾱ Ᾱ Ko e tohi mei heSocial Security kau ki he penefiti mālōlō-mei-he-ngāue, fakamatala ‘o e penefiti kuo ma’u, pe fakatokanga ma’u penisoni.

Foomu kole Me’atokoni Fakaako Ta’etotongi mo Totongi HolokiKo e tohi fakatokanga ki he ngaahi ‘api kuo tali/ta’e tali ‘a e penefiti Peesi 1 mei he 2Siulai 2011 - Tongan

TA’ENG UE, MAHAKI’IA FAKASINO, PE PA’ANGA HUHU’I ‘A E TOKOTAHA NG UE: Ᾱ Ᾱ Tohi fakangofua mei he ‘ofisi ‘o e State employment security, pati ‘o e sieke, pe tohi mei he ‘ofisi ‘o e Worker’s Compensation.

NGAAHI PA’ANGA MEI HE UELOFEA: Tohi penefiti mei he ‘ofisi [State TANF].

PA’ANGA TOKONI KI HE FANAU PE PE PA’ANGA HUHU’I: Tu’utu’uni faka-fakamaau’anga, aleapau, pengaahi tatau ‘o e sieke kuo ma’u.

PA’ANGA HU-MAI KEHE (HANGE KO E PA’ANGA HU-MAI MEI HE NOFO-TOTONGI) : Fakamatala tene fakaha ‘a e sino’i pa’anga hu-mai kuo ma’u, tu’o fiha hono ma’u, mo e ‘aho ne ma’u ai.

‘IKAI HA SINO’I PA’ANGA HU-MAI: ’Omai ha ki’i fakamatala nounou ‘a e founga ‘oku ke tokonaki ai ha me’atokoni, vala, pea mo e nofo’anga ki ho memipa-‘api, pea ‘e ma’u fakakū ha pa’anga hu-mai.

NOFO’ANGA FAKAĒKITA FAKAKAUTAU: Koha tohi pe tohi aleapau nofo’anga ‘oku fakaha ai ko e Nofo’anga Fakakautau ko eni ko e konga pe ia ‘o e Nofo’angaFakaēkita Fakakautau..

FAKAMATALA NOUNOU FAKATAIMI KAU KI HE PA’ANGA HU-MAI FE’UNGA: ‘Kataki ‘omai ha fakamatala fakamo’oni o e pa’anga hu-mai ‘i he māhina e taha; ‘e lava ke ke ‘omai ‘a e māhina kimu’a ‘i ho’o tohi kole, māhina ‘oku fai ai ho’o kole, pe ha mahina pe hili ho’o kole.

Kapau ‘oku ‘i ai ha ngaahi fehu’i pe fiema’u tokoni, kātaki fetu’utaki [name] ‘i he [phone number]. Ko e telefoni ‘oku ta’e totongi. [Toll free or reverse charge explanation] . ‘E lava pe ke ke ‘i-meili mai ‘i he [e-mail address].


[signature]

Ko e konga lao mei he Richard B. Russell National School Lunch Act ‘oku ne fiema’u ‘a e fakamatala ‘i he tohi kole ni. ‘Oku ke fa’iteliha pe teke ‘omai e fakamatala, pea kapau ‘e ‘ikai teke ‘omai, ‘e ‘ikai te mau fakangofua ho’o tama ki he ngaahi me’atokoni ta’e totongi pe me’atokoni totongi holoki. Te mau faka’aonga’i ho’o fakamatala ke fakapapau’i pe ‘oku ngofua ho’o tama ki he ngaahi me’atokoni ta’e totongi pe me’atokoni totongi holoki, pea ki he founga fakalele mo e fakamalohi’i ‘o e polokalama kai ho’ata mo pongipongi.



KUO MAU ‘OSI SIO KI HO’O TOHI KOLE

‘Apiako: ___________________________‘Aho: ______________________

Kia _________________________________________________:

Kuo mau ‘osi sivi’i ‘a e fakamatala na’a ke ‘omai ke fakamo’oni’i ko e [name(s) of child(ren)] ‘oku nau ngofua ki he ngaahi me’atokoni ta’etotongi pe me’atokoni totongi holoki pea ‘oku mau loto kiai Ko e kau/ngofua ho’o tama/fānau ‘oku ‘ikai liliu. ‘Aho kamata [date], ko e kau/ngofua ho’o tama/fānau ki he ngaahi me’atokoni ‘e liliu mei he me’atokoni totongi

holoki ki he me’atokoni ta’etotongi ko e’uhi ko ho’o sino’i pa’anga hu-mai ‘oku ‘i he ‘elia ‘o e me’atokoni ta’etotongi. Ko ho’o tama/fānau te nau ma’u me’atokoni ta’etotongi.

‘Ao kamata [date], Ko e kau/ngofua ho’o tama/fānau ki he ngaahi me’atokoni ‘e liliu me’atokoni ta’etotongi ki heme’atokoni totongi holoki ko e’uhi ko ho’o sino’i pa’anga hu-mai ‘oku ‘ova ia he fakangatangata. Ko e totongi ‘o e me’atokoni totongi holoki ‘oku [$] ki he kai ho’ata pea [$] ki he kai pongipongi.

‘Aho kamata [date], ko ho’o tama/fānau ‘oku ‘ikai toekau/ngofua ki he me’atokoni ta’etotongi pe me’atokoni totongi holoki ko e’uhi ko e ngaahi ‘uhinga ko eni:

___ ‘Oku fakaha mai ‘e he ngaahi fakamatala ‘oku ‘ikai ha taha ho ‘api ‘e ma’u penefit mei he [State SNAP] pe [State TANF].

___ ‘Oku fakaha mai ‘e he ngaahi fakamatala ko ho’o tama/fānau ‘oku ‘ikai ko e ta’e-ha-‘api, hola, pe nofo-fonua mai. ___ Ko ho’o sino’i pa’anga hu-mai ‘oku laka ia he limiti ki he ngaahi me’atokoni ta’etotongi pe me’atokoni totongi

holoki. ___ Na’e ‘ikai teke ‘omai: _____________________________________________________________________________________________ Na’e ‘ikai fai mai ha’o tali ki he ‘emau kole.

Ngaahi Totongi e me’atokoni [$] ki he kai ho’ata mo e [$] ki he kai pongipongi. Kapau ‘e holo ho’o sino’i pa’anga hu-mai pe koe tokolahi ho mēmipa-‘api ‘oku ‘alu ki ‘olunga, ‘e lava pe ke ke toe kole mai. Kapau na’e ‘ikai tali ki mu’a ho’o penefit koe’uhi na’e ‘ikai ha taha ho ‘api na’e ma’u penefit mei he [State SNAP], [State TANF] pe [FDPIR], ‘e lava pe keke toe kole makatu’unga he tu’unga pa’anga lolotonga. Kapau na’e ‘ikai ‘omai ha fakamo’oni, ’o e tu’unga pa’anga lolotonga, ‘e kole atu keke fai ia ‘o kapau teke toe kole mai.

Kapau ‘oku ke ta’e loto ki he tu’utu’ini, ‘e lava pe keke talanoa kia [name] ‘i he [phone]. ‘Ikai koia pe ka ‘oku ‘iai ho’o totonu ke fai ha talanoa ta’efilifilimānako kiai. Kapau teke kole ke fai ha talanoa kiai ‘i he [date], ko ho’o tama/fānau ‘e hoko atu pe ‘enau ma’u me’atokoni ta’etotongi pe me’atokoni totongi holoki kae’oua kuo ma’u ha tu’utu’uni faka-‘ofisi. ‘E lava pe keke kole ha taimi talanoa ta’efilifilimānako ‘aki ho’o telefoni pe tohi ki he [name], [address], [phone number], or [e-mail].


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Foomu kole Me’atokoni Fakaako Ta’etotongi mo Totongi HolokiKuo mau ‘osi sio ki ho’o tohi kolePeesi 1 mei he 1Siulai 2011 - Tongan

KO E TOHI FAKATOKANGA KI HE NGAAHI ‘API KUO TALI/TA’E TALI ‘A E PENEFITI


Na’a ke kole mai ki he me’atokoni ta’etotongi pe me’atokoni totongi holoki ki he tama/fānau ko eni:

_______________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ _______________________________________________________

Ko ho’o tohi kole na’e:

Na’e tali ki he ngaahi me’atokoni ta’etotongi

Na’e tali ki he ngaahi me’atokoni totongi holoki ki he $________ kai ho’ata, $_______ kai pongipongi, pea $______ kai ma’ama’a.

‘Ikai tali ko e ngaahi ‘uhinga eni:

Ko e sino’i pa’anga hu-mai ‘oku lahi ia he sino’i pa’anga ‘oku fiema’u

Ko e tohi kole na’e ‘ikai kakato hono fakafonu koe’uhi _______________________________________________________

‘Uhinga kehe_____________________________________________________________________________________________________

Kapau ‘oku ‘ikai te ke loto tatau mo e tu’utu’uni, ‘e lava pe keke talanoa kiai mo e [school official’s name] ‘i he [phone number] pe‘i he [e-mail address]. Kapau ‘oku ke loto ke toe fai ha sio ki he tu’utu’uni, ‘oku ‘i ai ho’o totonu ki ha toe sio ta’efilifilimānako. ‘E lava pe ‘o fai eni ‘i ha’o telefoni pe tohi ki he kau ‘ofisa ko eni:

HINGOA: _______________________________________________________________________________________________________________________________

TU’ASILA: _____________________________________________________________________________________________________________________________

FIKA TELEFONI: ____________________________ ‘I-MEILI________________________________________________________________________________


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___________________________________________________________________________________________________________________________________________Hingoa Lakanga ‘Aho



TOHI FAKATOKANGA ‘O E FAKAHOKO NGOFUA

Ki he Mātua/Tauhi-fānau:

‘Oku mau loto ke fakaha atu ke mou ‘ilo ko e tama/fānau ‘oku lisi atu ‘i lalo te na’u ma’u ‘a e me’atokoni ta’etotongi kai ho’ata, kai pongipongi, pea mo e kai ma’ama’a ‘i he ‘apiako koe’uhi ‘oku nau ma’u [State SNAP] pe [State TANF].

Hingoa ‘o e Tama Hingoa ‘o e ‘Apiako

Kapau ‘oku ‘i ai ha fānau kehe ‘i ho ‘api ‘oku ‘ikai ‘asi ho nau hingoa he lisi ‘i ‘olunga, pea ‘oku ngofua ke nau kau ki he ma’u ‘o e ngaahime’atokoni ta’etotongi.

Kapau ‘oku pehē, kātaki ‘o fetu’utaki ki he ‘apiako ‘oku ‘i ai ho’o tama/fānau:

Kapau ‘oku ‘i ai ha fānau ‘i ho mēmipa-‘api ‘oku ‘ikai ‘asi ho nau hingoa ‘i ‘olunga pea ‘oku ke fiema’u ke nau ma’u me’atokoni ta’etotongi mei he ‘apiako

‘Oku ‘ikai teke fiema’u ho’o fānau ke kau he ma’u e ngaahi me’atokoni ta’e totongi

‘Oku ‘i ai ha’o toe fehu’i kehe

[name]

[phone number]

[e-mail address]


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Foomu kole Me’atokoni Fakaako Ta’etotongi mo Totongi HolokiTohi Fakatokanga ‘o e Fakahoko FatongiaPeesi 1 mei he 1Siulai 2011 - Tongan

2011 Application & Instructions -...

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