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Child and Adult Care Food ProgramAllocation Formula (Used for Claiming Indirect Costs)This form must be completed by all sponsors who wish to have indirect costs allocated to the Child and Adult Care Food Program (CACFP). Costs claimed that have not received prior approval from the state will not be included in costs used to determine nonprofit meal service. (Please consult FNS Instruction 796-2 Revision 4 for specific costs requiring prior written approval or for costs that should be included in your annual budget.) Indirect costs benefit more than one function or activity, but cannot be easily identified or assigned. Indirect costs can benefit both allowable and unallowable activities. Examples include:Depreciation and use allowances on buildings and equipment used for common purposes;Costs of operating and maintaining facilities; andSalaries for office receptionist, central accounting staff and building janitor. The approved allocation formula will become a part of your permanent records at the state agency. If you have changes in the cost categories used to arrive at your allowable percentage you must re-apply for the allocation formula and submit the revised documentation. Complete the following to determine your allocation formula rate. Provide a detailed building floor plan, including the dimensions of specific rooms/areas listed below.What is the square footage of your dining area? __________________ Sq. ft. What is the square footage of your kitchen and food storage? ___________________ Sq. ft.Add a and b together __________ Sq. ft. (CACFP related Sq. ft.)What is the total square footage of your center? ______________ Sq. ft. _____________________ divided by _________________________ = _______________________ (c) CACFP related Sq. ft.) (d) Total Sq. ft. % used for allocation rateThe information submitted above is being used to uniformly allow for the claiming of indirect costs that, in part, related to the operation of the CACFP. As the program owner, director or CACFP administrator, I certify this information is accurate and has been verified prior to submission to the state agency for approval.________________________________________________________________________ Name of Sponsor Representative Date________________________________________________________________________ Name of State Agency Representative DateRevised 12/16 ................
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