*Note: You must have certified on the Registration page to the below, in order to be eligible to receive this food. Ordering this food without certifying on the registration page will result in this item being removed from your order.
I certify that my yearly gross income is at or below that income listed on this form for households with the same number of people as my household, OR that my household participates in the TEFAP program. I also certify that, as of today, my household lives in the County of Honolulu. This certification form is being completed in connection with the receipt of Federal assistance. Per State policy, program officials may verify what I have certified to be true. I understand that making a false statement may result in having to pay the State for the value of the food improperly issued to me and may subject me to criminal prosecution under State and Federal law.