Dear Parent/Guardian:

Welcome back! I hope that you and your child had an enjoyable summer and that both of you are looking forward to an exciting new school year. Our number one priority in the Santa Ana Unified School District is to provide the best educational program and services to support your child’s success. As our partner in education, we need your assistance to ensure that this occurs by completing a School Programs Funding Verification Form.

As part of a State requirement to determine how our school district will be funded, we must obtain a School Programs Funding Verification Form for each household by October 29, 2021. If you have multiple children in the District, you will only need to complete one form and list all of your children on the same form.

It is very important to read through these instructions, as incomplete forms cannot be processed. Completed forms will assist us in ensuring our District receives the necessary resources to continue preparing all students for college and career. If you need help completing the form, please contact Maribel Moran at 714-431-1900.

General Instructions:

• Submit one verification form per household
• Include all district enrolled students in grades K-12
• Include a parent/guardian signature
• List current home address
• Use the student’s legal first and last name
• Correct birth date must be entered

Frequently Asked Questions:

1. Is the School Verification Funding Form used to provide school breakfast and lunch benefits?
   
   No, this form is not for the student meals.  The District needs this form completed to comply with a new California law that requires all school districts to collect household income information.  All information provided by families will be kept strictly confidential and not shared with any third party.

2. What if not all children are attending Santa Ana USD schools?
   
   Please only list your children that are enrolled in Santa Ana USD schools in the Section 3, all others will be counted as part of the total household members in Section 4.

3. My spouse doesn’t work and has no income – should I include him/her on the verification form?
   
   Yes, All family members (Adult and children) part of the household size should be counted as part of the household income, regardless if there is no income for some members.

4. There are a lot of deductions on my paycheck. Can I list my “take home” pay?
   
   No, you must use the gross pay before deductions on your pay stub.

5. Who should sign the verification form?
   
   The parent/guardian who completed the form must sign their name or enter an electronic signature (online).

6. Does the person who earns income for the family have to fill out the verification form?
   
   No, the verification form can be filled out by any parent or guardian of the household.

7. Do I need to total all of my household income and enter it as one income?
   
   Yes, fill in the appropriate bubble that matches your total household monthly income range.

8. I get paid weekly and every two weeks because I have two jobs, how should I enter my earnings?
   
   Use the following income calculations to get a monthly total. Gross Income (before deductions).
   
   If you are paid:
   
   

   Weekly:	Gross X 52 ÷ 12
   Every two weeks (Bi-weekly):	Gross X 26 ÷ 12
   Twice a month:	Gross X 24 ÷ 12
   Annual:	Gross ÷ 12

   
   
   For Example: $100.20/week and $350.60 every two weeks:
   100.20 X 52 ÷ 12 = $434.20/month and 350.60 x 26 ÷ 12 = $759.63/month
   add all totals 434.20 + 759.63 = $1,193.83.
   Total household income (in whole dollars) $1,194/month

9. I receive income in addition to what I earn at my job.  Do I include this income?
   
   Yes, if it is income you normally receive in a typical month. For example, Child Support income, Welfare Benefits, Alimony payments, or rent from a rental property.

10. I am currently unemployed.  What should I list as my income?
    
    Please provide any income used in the last 30 days in your household or if NO Income, then bubble in the Category 1 box next to your total household size.

For additional information on Household Size and Gross Household Income, please see the Eligibility Manual for School Meals on the U.S. Department of Agriculture Guidance and Resource Web page at https://www.fns.usda.gov/cn/guidance-and-resources.