USDA Forms
Other Information
TEFAP Quarterly Report Continuation Page
1st Quarter Due- October 15
2nd Quarter Due- January 15
3rd Quarter Due- April 15
4th Quarter Due- July 15
Reports must be mailed or e-mailed by the close of business on dates listed above.
FAXED REPORTS WILL NOT BE ACCEPTED!
Mail reports to:
Mountaineer Food Bank
484 Enterprise Dr. Gassaway, WV 26624 or
Email reports to:
Reports@MountaineerFoodBank.org
in the subject line type 'Your Pantry Quarterly Report'
TEFAP Recipient Application / Means Test
Nondiscrimination Statement for TEFAP Documentation
USDA Civil Rights Compliance in the Food Distribution Programs
Civil Rights Discrimination Complaint Form
Civil Rights Discrimination Complaint Form Instructions
Civil Rights Discrimination Complaint Form SPANISH
Civil Rights Discrimination Complaint Form Instructions SPANISH
USDA TEFAP Civil Rights-Media Release
USDA TEFAP CSFP Beneficiary Referral Request
USDA CSFP Beneficiary Notice of Beneficiary Rights
USDA TEFAP Beneficiary Notice of Beneficiary Rights
Food Distribution National Policy Memorandum
Additional Documents
Reporting Forms
Food Safety Training
One representative from each agency must be trained by MFB. Certification is valid for 2 years. If you have questions about your agency's status email Reports@MountaineerFoodbank.org
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race,color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.
Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:
(1) Mail: U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410;
(2) Fax: (202) 690-7442; or
(3) Email: program.intake@usda.gov.
This institution is an equal opportunity provider.