Additional Documents
Other Information
2024/2025 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
In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.
Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible State or local Agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.
To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA.
The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted 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; or
(2) fax:
(833) 256-1665 or (202) 690-7442; or
(3) email:
This institution is an equal opportunity provider.
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