Virginia Fresh Match Reimbursement Request

Virginia Fresh Match

Reimbursement Request

Use this report to request reimbursement for your

monthly VFM incentive expenses. LEAP processes

reports on the 15th of each month.

Outlet Name*

Select or enter value

Please identify your outlet category.*

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Report month*

Select

Number of Fruit and Vegetable Vendors*

Average number of vendors each month is acceptable. Please to not double count vendors.

For retail, please report the number of local farmers your outlet procured food from this month.

Total Operating Days this Month*

Or how many days your outlet was open.

Average Operating Hours per day*

Or the number of hours you operated each day this month.

Dollar Value of Incentives (VFM) Issued*

How much in VFM you issued to customers.

Dollar Value of Incentives (VFM) Redeemed*

How much in VFM was spent at your outlet.

Number of Transactions Using Incentives (VFM)*

Or how many transactions in which you provided the incentive to customers. (tokens or discount). If unknown, please approximate.

Dollar Value of SNAP (EBT) Purchased*

How much in SNAP you issued to customers.

Dollar Value of SNAP (EBT) Redeemed*

How much in VFM was spent at your outlet.

Number of SNAP (EBT) Transactions*

Or how many transactions in which customers swiped their EBT card and received SNAP tokens at the market booth/office.

Number of Eligible Participants*

Or customers able to receive the SNAP incentive.

Number of Unique Incentive Customers*

Upload supporting documentation

Documentation must confirm the total VFM redeemed you report.

Drag and drop files here or

Send me a copy of my responses