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State Plan Checklist - CERTIFICATION, ELIGIBILITY & COORDINATION OF SERVICES 8/14/2026 Page 6

d. The State agency uses documented eligibility for participation in other means-tested programs to establish automatic WIC income eligibility (check all that apply, and the poverty levels used for each): N/A

Poverty Level (%) Free or Reduced-Price School Meals Supplemental Security Income (SSI) Other State-provided health insurance (specify State ''percent of poverty'' maximum Food Distribution Program on Indian Reservations (FDPIR)