Sample_PFS_for_Documenting_Grains_Ounce_Equivalent_in_Child_Nutrition_Program.pdf

Product Formulation Statement for Documenting Grains Ounce Equivalents in Child Nutrition Programs

Crediting Standards Based on Grams of Creditable Grains Program operators have the option to choose the crediting method that fits their specific menu planning needs.

Food manufacturers/vendors must: 1. Provide the following information on company letterhead signed by an official company representative. 2. Use Exhibit A: Grain Requirements for Child Nutrition Programs (Exhibit A) in the “Food Buying Guide for Child Nutrition Programs” (FBG) to complete this form. 3. Provide a copy of the ingredient list from the product package.

Product Name:

Sunshine Wheat Pancakes

Code No.:

14025

Manufacturer:

ABC Baked Goods Serving Size: 2 pancakes - 50 g (1.75 oz)

I. Does the product meet the whole grain-rich* criteria? Yes X No

* Whole grain-rich is the term designated by Food and Nutrition Service to indicate that the grain content of a product is between 50 and 100 percent whole grain with any remaining grains being enriched.

II. Does the product contain noncreditable grains? Yes No X How many grams?

(Products with more than 0.24 ounce equivalent (oz eq) or 3.99 grams (g) for Groups A–G or 6.99g for Groups H and I of noncreditable grains do not credit toward the grains requirement for school meals.)

III. Use Exhibit A to determine if the product fits into Groups A–G (baked goods), Group H (cereal grains) or Group I (RTE breakfast cereals). (Different methodologies are applied to calculate the grains contribution based on creditable grains.

Groups A–G use the standard of 16g creditable grains per oz eq; Groups H and I use the standard of 28g creditable grains per oz eq or volume.)

Indicate which Exhibit A Group (A–I) the product belongs: C

DESCRIPTION OF CREDITABLE

GRAIN INGREDIENT 1

GRAMS OF

CREDITABLE GRAIN

INGREDIENT PER

PORTION2

A

GRAM STANDARD OF

CREDITABLE GRAINS

PER OZ EQ

(16g or 28g)3

B

CREDITABLE

AMOUNT

A ÷ B

Whole wheat flour 15 16 0.9375 Enriched flour 11 16 0.6875

Total 1.625 Total Creditable Amount4 1.50

1 Creditable grains vary by Program. See the FBG for specific Program requirements.

2 (Serving size in grams) X (% of creditable grains in formula); raw dough weight may be used for serving size. Serving sizes other than grams must be converted to grams.

3 Standard grams of creditable grains from the corresponding Group in Exhibit A.

4 Total Creditable Amount must be rounded down to the nearest quarter (0.25) oz eq. Do not round up.

Total weight (per portion) of product as purchased 50 g (1.75 oz)

Total creditable amount of product (per portion) 1.50 oz eq

I certify that the above information is true and correct and that a 1.75 ounce portion of this product (ready for serving) provides 1.50 oz eq grains.

For school meals only: I further certify that noncreditable grains are not above 0.24 oz eq per portion. Products with more than 0.24 oz eq or 3.99g for Groups A–G or 6.99g for Groups H and I of noncreditable grains do not credit toward the grains requirement for school meals.

Signature Title

Printed Name Date Phone Number

ABC Baked Goods

K-12 Regulatory Compliance Specialist

09/01/2025 123-456-7890Jane Hudson

EXAMPLE

https://foodbuyingguide.fns.usda.gov/Content/TablesFBG/Exhibit_A_Grain_Requirements_For_Child_Nutrition_Programs.pdf

Product Formulation Statement for Documenting Grains Ounce Equivalents in Child Nutrition Programs

Crediting Standards Based on Exhibit A Weights Program operators have the option to choose the crediting method that fits their specific menu planning needs.

Food manufacturers/vendors must: 1. Provide the following information on company letterhead signed by an official company representative. 2. Use Exhibit A: Grain Requirements for Child Nutrition Programs (Exhibit A) in the “Food Buying Guide for Child Nutrition Programs” (FBG) to complete this form. 3. Provide a copy of the ingredient list from the product package.

Product Name:

Sunshine Wheat Pancakes Code No.:

14025

Manufacturer:

ABC Baked Goods Serving Size:

2 pancakes - 50 g (1.75 oz)

I. Does the product meet the whole grain-rich* criteria? Yes X No

* Whole grain-rich is the term designated by Food and Nutrition Service to indicate that the grain content of a product is between 50 and 100 percent whole grain with any remaining grains being enriched.

II. Does the product contain noncreditable grains? Yes No X How many grams?

(Products with more than 0.24 ounce equivalent (oz eq) or 3.99 grams (g) for Groups A–G and 6.99g for Groups H and I of noncreditable grains do not credit toward the grains requirement for school meals.)

III. Use Exhibit A to determine if the product fits into Groups A–G (baked goods), Group H (cereal grains) or Group I (RTE breakfast cereals). (Different methodologies are applied to calculate the grains contribution based on creditable grains.

Groups A–G use the standard of 16g creditable grain per oz eq; Groups H and I use the standard of 28g creditable grains per oz eq or volume.)

Indicate which Exhibit A Group (A–I) the product belongs: C

DESCRIPTION OF PRODUCT

PER EXHIBIT A

PORTION SIZE

OF PRODUCT AS

PURCHASED

A

WEIGHT OF ONE

OZ EQ AS LISTED IN

EXHIBIT A

B

CREDITABLE

AMOUNT

A ÷ B

Pancakes 50 g 34 g 1.47 Total Creditable Amount1 1.25

1 Total Creditable Amount must be rounded down to the nearest quarter (0.25) oz eq. Do not round up.

Total weight (per portion) of product as purchased 50 g

Total creditable amount of product (per portion) 1.25 oz eq

I further certify that the above information is true and correct and that a 1.75 ounce portion of this product (ready for serving) provides 1.25 oz eq grains.

For school meals only: I further certify that noncreditable grains are not above 0.24 oz eq per portion. Products with more than 0.24 oz eq or 3.99g for Groups A–G or 6.99g for Groups H and I of noncreditable grains do not credit toward the grains requirement for school meals.

Signature Title

Printed Name Date Phone Number

ABC Baked Goods

K-12 Regulatory Compliance Specialist

09/01/2025 123-456-7890Jane Hudson

Using the Exhibit A Weights method, the creditable amount is 1.25 compared to the creditable amount of 1.50 using the Grams Creditable Grains method. Both are acceptable.EXAMPLE https://foodbuyingguide.fns.usda.gov/Content/TablesFBG/Exhibit_A_Grain_Requirements_For_Child_Nutrition_Programs.pdf