APPENDIX A
CERTIFICATION AND PARTICIPATION DATA REQUEST
Evaluation of Demonstrations of
NSLP/SBP Direct Certification of
Children Receiving Medicaid Benefits
(OMB
No.:  0584-Xxxx
Expiration
Date: xx/xx/20xx)
Project Officer: Allison Magness
Office: U.S. Department of Agriculture
Food and Nutrition Service
3101 Park Center Dr., Rm. 1014
Alexandria, VA 22302
Telephone: 703-305-2098
FAX: 703-305-2576
Email: Allison.Magness@fns.usda.gov
CONTENTS
APPENDIX A.1: CERTIFICATION AND PARTICIPATION DATA REQUEST 3
APPENDIX A.2: CERTIFICATION AND PARTICIPATION DATA REQUEST Cover email 8
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Robert S. Akin | 
| File Modified | 0000-00-00 | 
| File Created | 2021-01-29 |