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☒ Yes, with no local agency exceptions ☐ Yes, with local agency variation ☐ No, with no local agency exceptions (specify State maximum percent of poverty: Click or tap here to enter text. %)

☐ No, with local agency variation (specify State maximum percent of poverty: Click or tap here to enter text. %)

ADDITIONAL DETAIL: Certification and Eligibility Appendix and/or Procedure Manual (citation): Click or tap here to enter text.

b. The State agency implements income eligibility guidelines concurrently with Medicaid ☐ Yes ☒ No

ADDITIONAL DETAIL: Please attach a copy of the income guidelines in the Appendix or the appropriate citation in the Procedure Manual. Certification and Eligibility Appendix and/or Procedure Manual (citation): Appendix VIII.A.4.a. WIC Income Eligibility Table

c. The State agency requires documentation of an applicant's, or certain family members' eligibility to receive benefits in the following means-tested programs that confer adjunctive income eligibility for WIC, as set forth in 7 CFR 246.7(d)(2)(vi): Poverty Level ☒ TANF (specify State "percent of poverty") 115% ☒ SNAP 130% ☒ Medicaid (specify State "percent of poverty" for each) Click or tap here to enter text.% ☒ Pregnant women and infants 306% ☒ Children 306% ☒ Other categorically eligible women 100% 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):

Poverty Level

☐ Free or Reduced-Price School Meals Click or tap here to enter text.% ☐ Supplemental Security Income (SSI) Click or tap here to enter text.%

☐ Other State-provided health insurance (specify State "percent of poverty" maximum Click or tap here to enter text. %)Click or tap here to enter text.%