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State Plan Checklist - NUTRITION SERVICES 8/14/2026 Page 24

Infants 0-5 months (FP I) X Infants 6-11 months (FP II) X Children 12 through 23 months (FP IV-A) X Children 2 through 4 years (FP IV-B) X

i. WIC Formulas:

(1) The State agency establishes policies regarding the issuance of primary contract, contract, and non-contract brand infant formula. Yes No

(2) The State agency requires medical documentation for contract infant formula (that does not meet the requirements in Table 4 at 7 CFR 246. 10(e)(12) per 246. 10(d)(1)(vi)). Yes No

(3) The State agency requires medical documentation for contract formula (other than primary contract formula per 7 CFR 246. 16a(c)(9). Yes No (4) The State agency requires medical documentation for non-contract infant formula. Yes No