65318.52600\40063921.1
ARPA BENEFICIARY CHECKLIST
BENEFICIARY CATEGORY C RITERIA CRITERIA
MET?
Individuals and
Households
Household income at or below 300 percent of the
Federal Poverty Guidelines or 65 percent of the
area median?
Did the individual or anyone in the household
experience unemployment during the pandemic?
Did the individual or household experience
increased food or housing insecurity during or as a
result of the pandemic?
Does the individual live in or is the household
located in a Qualified Census Tract?
Does the individual or anyone in the household
qualify for any of the following federal benefits:
Medicaid/MediCal
Children’s Health Insurance Program
(CHIP)
Child Care Development Fund (CCDF)
Temporary Assistance for Needy Families
(TANF)
Supplemental Nutrition Assistance
Program (SNAP)
Free-and Reduced-Priced Lunch (NSLP)
and/or School Breakfast (SBP) programs;
Medicare Part D Low-Income Subsidies
Supplemental Security Income (SSI)
Head Start and/or Early Head Start
Exhibit A
65318.52600\40063921.1
Special Supplemental Nutrition Program
for Women, Infants, and Children (WIC)
Section 8 Vouchers
Low-Income Home Energy Assistance
Program (LIHEAP)
Pell Grants
National Housing Trust Fund
Home Investment Partnerships Program
If any of the above criteria met, the individual or household are a Beneficiary
65318.52600\40063921.1
Small Businesses Does the business meet the following:
have 500 or fewer employees
is independently owned and operated
is not the dominant business in its field of
operation
Is the business located in a Qualified Census
Tract?
Did the business experience financial insecurity
during the pandemic?
Did the business incur decreased revenue or gross
receipts during or as a result of the pandemic?
Did the business experience increased costs as a
result of the pandemic?
Did the business experience challenges covering
payroll, rent or mortgage, and other operating
costs as a result of the pandemic?
If first criteria and any of the other criteria are met, the business is a beneficiary
65318.52600\40063921.1
Nonprofit Organizations Is the nonprofit organized as a 501(c)(3) or 501(c)(19) tax exempt organization?
Is the non-profit is based in or does it serve a
Qualified Census Tract?
Did the non-profit experience decreased revenue
(i.e. from donations and fees) as a result of (or
during) the pandemic?
Did the non-profit experience increased costs (i.e.
uncompensated increases in service need) as a
result of the pandemic?
Did the non-profit experience financial insecurity
as a result of the pandemic?
Did the non-profit experience challenges covering
payroll, rent or mortgage, and other operating
costs as a result of the pandemic?
If the nonprofit is a 501(c)(3) or 501(c)(19) and any of the above criteria are met, it is a Beneficiary
65318.52600\40063921.1
Impacted Industries Does the business operate in the travel, tourism or hospitality sector?
Does the business operate in an industry that on
the local or national level:
Experienced at least 8 percent employment
loss from pre-pandemic levels, or
Is experiencing comparable or worse
economic impacts as the national tourism,
travel, and hospitality industries as of the date
of the final rule
If either criteria are met, the business is a Beneficiary