| ACCESS - MyACCESS Account Brochure (PDF, 202 KB)
|
P-00219
|
PDF
|
9/1/2010
|
English
|
| ACCESS - MyACCESS Account Brochure - Spanish
|
P-00219S
|
PDF
|
9/1/2010
|
Spanish
|
| ACCESS Business Card (PDF, 41 KB)
|
P-16077
|
PDF
|
9/1/2010
|
English
|
| ACCESS Business Card - Spanish (PDF, 45 KB)
|
P-16077S
|
PDF
|
9/1/2010
|
Spanish
|
| ACCESS Poster (PDF, 445 KB)
|
P-16084
|
PDF
|
9/1/2010
|
English
|
| ACCESS Poster - Spanish (PDF, 448 KB)
|
P-16084S
|
PDF
|
9/1/2010
|
Spanish
|
| ACCESS Poster Tear Off Sheet (PDF, 137 KB)
|
P-16084A
|
PDF
|
9/1/2010
|
English
|
| ACCESS Poster Tear Off Sheet - Spanish (P-DF, 35 KB)
|
P-16084AS
|
PDF
|
9/1/2010
|
Spanish
|
| Administrative Disqualification Hearing Notice (PDF, 81 KB)
|
F-16038
|
PDF
|
10/1/2011
|
English
|
| Affidavit of Return or Exchange of Food Coupons (PDF, 615 KB)
|
F-19002
|
PDF
|
12/1/1997
|
English
|
| Agency Response to the State Quality Assurance (QA) FoodShare (FS) Finding (PDF, 183 KB)
|
F-16050
|
PDF
|
7/1/2008
|
English
|
| BadgerCare Plus Supplement to FoodShare Wisconsin Application (PDF, 654 KB)
|
F-10138
|
PDF
|
7/1/2008
|
English
|
| Consortium Response to the State IM Second Party Review Finding
|
F-00628
|
Word
|
7/1/2012
|
English
|
| Consortium Response to the State IM Second Party Review Finding (PDF, 25 KB)
|
F-00628
|
PDF
|
7/1/2012
|
English
|
| Designation of Authorized Buyer / Alternate Payee for FoodShare Benefits (PDF, 32 KB)
|
F-16004
|
PDF
|
7/1/2008
|
English
|
| Designation of Authorized Buyer / Alternate Payee for FoodShare Benefits - Hmong (PDF, 31 KB)
|
F-16004H
|
PDF
|
7/1/2008
|
Hmong
|
| Designation of Authorized Buyer / Alternate Payee for FoodShare Benefits - Spanish (PDF, 33 KB)
|
F-16004S
|
PDF
|
7/1/2008
|
Spanish
|
| Disaster FoodShare Wisconsin Assistance Application (PDF, 67 KB)
|
F-16060
|
PDF
|
2/1/2012
|
English
|
| Disaster FoodShare Wisconsin Assistance Application - Spanish (PDF, 75 KB)
|
F-16060S
|
PDF
|
2/1/2012
|
Spanish
|
| Disqualification Consent Agreement (PDF, 46 KB)
|
F-16025
|
PDF
|
11/1/2012
|
English
|
| Disqualification Consent Agreement - Spanish (PDF, 31 KB)
|
F-16025S
|
PDF
|
11/1/2011
|
Spanish
|
| Employment Verification of Earnings
|
F-10146
|
Word
|
7/1/2008
|
English
|
| FoodShare and/or Child Care Six Month Report
|
F-16076
|
Word
|
1/1/2012
|
English
|
| FoodShare and/or Child Care Six Month Report (Hmong)
|
F-16076H
|
Word
|
1/1/2012
|
Hmong
|
| FoodShare and/or Child Care Six Month Report - Spanish
|
F-16076S
|
Word
|
1/1/2012
|
Spanish
|
| FoodShare and/or Child Care Six Month Report Form Instructions
|
F-16076A
|
Word
|
1/1/2012
|
English
|
| FoodShare and/or Child Care Six Month Report Form Instructions - Hmong
|
F-16076AH
|
Word
|
1/1/2012
|
Hmong
|
| FoodShare and/or Child Care Six Month Report Form Instructions - Spanish
|
F-16076AS
|
Word
|
1/1/2012
|
Spanish
|
| FoodShare Employment and Training (FSET) Participation Agreement (PDF, 37 KB)
|
F-00136
|
PDF
|
2/1/2012
|
English
|
| FoodShare Employment and Training (FSET) Participation Agreement - Hmong (PDF, 41 KB)
|
F-00136H
|
PDF
|
2/1/2012
|
Hmong
|
| FoodShare Employment and Training (FSET) Participation Agreement - Spanish (PDF, 40 KB)
|
F-00136S
|
PDF
|
2/1/2012
|
Spanish
|
| FoodShare Renewal Request for a Closed Case
|
F-00363
|
Word
|
1/1/2011
|
English
|
| FoodShare Renewal Request for a Closed Case - Hmong
|
F-00363H
|
Word
|
1/1/2011
|
Hmong
|
| FoodShare Renewal Request for a Closed Case - Spanish
|
F-00363S
|
Word
|
1/1/2011
|
Spanish
|
| FoodShare Wisconsin - FoodShare (SNAP) for Seniors and People with Disabilities Fact Sheet (PDF, 65 KB)
|
P-16013
|
PDF
|
2/1/2012
|
English
|
| FoodShare Wisconsin - FoodShare and / or Child Care Six Month Report Form Fact Sheet (PDF, 93 KB)
|
P-16078
|
PDF
|
2/1/2012
|
English
|
| FoodShare Wisconsin - FoodShare and / or Child Care Six Month Report Form Fact Sheet - Spanish (PDF, 84 KB)
|
P-16078S
|
PDF
|
2/1/2012
|
Spanish
|
| FoodShare Wisconsin - FoodShare for Senior Citizens and People with Disabilities Fact Sheet - Spanish (PDF, 200 KB)
|
P-16013S
|
PDF
|
2/1/2012
|
Spanish
|
| FoodShare Wisconsin - FoodShare Makes Wisconsin Healthier Brochure (PDF, 65 KB)
|
P-16063
|
PDF
|
2/1/2012
|
English
|
| FoodShare Wisconsin - FoodShare Makes Wisconsin Healthier Brochure - Spanish (PDF, 302 KB)
|
P-16063S
|
PDF
|
10/1/2009
|
Spanish
|
| FoodShare Wisconsin - FoodShare Makes Wisconsin Healthier Fact Sheet (PDF, 93 KB)
|
P-16062
|
PDF
|
2/1/2012
|
English
|
| FoodShare Wisconsin - FoodShare Makes Wisconsin Healthier Fact Sheet - Hmong (PDF, 153 KB)
|
P-16062H
|
PDF
|
2/1/2012
|
Hmong
|
| FoodShare Wisconsin - FoodShare Makes Wisconsin Healthier Fact Sheet - Spanish (PDF, 155 KB)
|
P-16062S
|
PDF
|
2/1/2012
|
Spanish
|
| FoodShare Wisconsin - FoodShare Quality Assurance Review Fact Sheet (PDF, 59 KB)
|
P-16000
|
PDF
|
2/1/2012
|
English
|
| FoodShare Wisconsin - FoodShare Quality Assurance Review Fact Sheet - Hmong (PDF, 46 KB)
|
P-16000H
|
PDF
|
2/1/2012
|
Hmong
|
| FoodShare Wisconsin - FoodShare Quality Assurance Review Fact Sheet - Spanish (PDF, 45 KB)
|
P-16000S
|
PDF
|
2/1/2012
|
Spanish
|
| FoodShare Wisconsin - QUEST Card Mailer / Wallet Card Only (PDF, 62 KB)
|
P-16075
|
PDF
|
10/1/2008
|
English
|
| FoodShare Wisconsin - QUEST Card Mailer / Wallet Card Only - Hmong (PDF, 86 KB)
|
P-16075H
|
PDF
|
11/1/2007
|
Hmong
|
| FoodShare Wisconsin - QUEST Card Mailer / Wallet Card Only - Russian (PDF, 85 KB)
|
P-16075R
|
PDF
|
11/1/2007
|
Russian
|
| FoodShare Wisconsin - QUEST Card Mailer / Wallet Card Only - Spanish (PDF, 90 KB)
|
P-16075S
|
PDF
|
11/1/2007
|
Spanish
|
| FoodShare Wisconsin - Transitional FoodShare Benefits Fact Sheet (PDF, 113 KB)
|
P-16074
|
PDF
|
2/1/2012
|
English
|
| FoodShare Wisconsin - Transitional FoodShare Benefits Fact Sheet - Spanish (PDF, 134 KB)
|
P-16074S
|
PDF
|
2/1/2012
|
Spanish
|
| FoodShare Wisconsin - Your FoodShare Rights Poster
|
P-00102
|
Paper
|
2/1/2012
|
English
|
| FoodShare Wisconsin - Your FoodShare Rights Poster (Hmong)
|
P-00102H
|
Paper
|
2/1/2012
|
Hmong
|
| FoodShare Wisconsin - Your FoodShare Rights Poster (Spanish)
|
P-00102S
|
Paper
|
2/1/2012
|
Spanish
|
| FoodShare Wisconsin Application / Registration (PDF, 215 KB)
|
F-16019B
|
PDF
|
10/1/2012
|
English
|
| FoodShare Wisconsin Application / Registration - Hmong (PDF, 243 KB)
|
F-16019BH
|
PDF
|
10/1/2012
|
Hmong
|
| FoodShare Wisconsin Application / Registration - Spanish (PDF, 350 KB)
|
F-16019BS
|
PDF
|
10/1/2012
|
Spanish
|
| FoodShare Wisconsin Change Report (PDF, 110 KB)
|
F-16006
|
PDF
|
2/1/2012
|
English
|
| FoodShare Wisconsin Change Report - Hmong (PDF, 68 KB)
|
F-16006H
|
PDF
|
2/1/2012
|
Hmong
|
| FoodShare Wisconsin Change Report - Spanish (PDF, 116 KB)
|
F-16006S
|
PDF
|
2/1/2012
|
Spanish
|
| FoodShare Wisconsin Income Change Report (PDF, 45 KB)
|
F-16066
|
PDF
|
10/1/2012
|
English
|
| FoodShare Wisconsin Income Change Report - Hmong (PDF, 38 KB)
|
F-16066H
|
PDF
|
10/1/2012
|
Hmong
|
| FoodShare Wisconsin Income Change Report - Spanish (PDF, 37 KB)
|
F-16066S
|
PDF
|
10/1/2012
|
Spanish
|
| FoodShare Wisconsin Nonfinancial Worksheet (PDF, 214 KB)
|
F-16073
|
PDF
|
8/1/2008
|
English
|
| FoodShare Wisconsin Registration / Important Information (PDF, 565 KB)
|
F-16019A
|
PDF
|
10/1/2012
|
English
|
| FoodShare Wisconsin Registration / Important Information - Hmong (PDF, 56 KB)
|
F-16019AH
|
PDF
|
10/1/2012
|
Hmong
|
| FoodShare Wisconsin Registration / Important Information - Spanish (PDF, 53 KB)
|
F-16019AS
|
PDF
|
10/1/2012
|
Spanish
|
| FoodShare Wisconsin Repayment Agreement (PDF, 108 KB)
|
F-16029
|
PDF
|
7/1/2008
|
English
|
| FoodShare Wisconsin Repayment Agreement - Spanish (PDF, 113 KB)
|
F-16029S
|
PDF
|
7/1/2008
|
Spanish
|
| FoodShare Wisconsin Under / Over Issuance Worksheet (PDF, 35 KB)
|
F-16030
|
PDF
|
7/1/2011
|
English
|
| FoodShare Worksheet (PDF, 45 KB)
|
F-16033
|
PDF
|
7/1/2011
|
English
|
| ForwardHealth Enrollment and Benefits Handbook (PDF, 3.2 MB)
|
P-00079
|
PDF
|
12/1/2012
|
English
|
| ForwardHealth Enrollment and Benefits Handbook - Spanish (PDF, 867 KB)
|
P-00079S
|
PDF
|
12/1/2012
|
Spanish
|
| Guide to Applying for Wisconsin Health, Nutrition and Other Programs (PDF, 212 KB)
|
P-16091
|
PDF
|
7/1/2012
|
English
|
| Guide to Applying for Wisconsin's Health and Nutrition Programs - Hmong (PDF, 248 KB)
|
P-16091H
|
PDF
|
1/1/2011
|
Hmong
|
| Guide to Applying for Wisconsin's Health and Nutrition Programs - Spanish (PDF, 279 KB)
|
P-16091S
|
PDF
|
1/1/2011
|
Spanish
|
| Income Maintenance Quality Assurance (IMQA) Web Request (PDF, 32 KB)
|
F-16083
|
PDF
|
8/1/2011
|
English
|
| Life Insurance Inquiry
|
F-10144
|
Word
|
7/1/2008
|
English
|
| Local Agency Customer Feedback (PDF, 17 KB)
|
F-16104
|
PDF
|
11/1/2009
|
English
|
| Local Agency Customer Feedback - Spanish (PDF, 16 KB)
|
F-16104S
|
PDF
|
11/1/2009
|
Spanish
|
| Medicaid / BadgerCare Plus / FoodShare Wisconsin Authorization of Representative (PDF, 192 KB)
|
F-10126
|
PDF
|
2/1/2013
|
English
|
| Medicaid / BadgerCare Plus / FoodShare Wisconsin Authorization of Representative - Hmong (PDF, 242 KB)
|
F-10126H
|
PDF
|
7/1/2008
|
Hmong
|
| Medicaid / BadgerCare Plus / FoodShare Wisconsin Authorization of Representative - Spanish (PDF, 529 KB)
|
F-10126S
|
PDF
|
7/1/2008
|
Spanish
|
| Milwaukee Enrollment Services (MilES) Contact Poster Tear Off Sheets - Spanish
|
P-00084AS
|
Paper
|
1/1/2010
|
Spanish
|
| Milwaukee Enrollment Services (MilES) Contact Poster
|
P-00084
|
Paper
|
1/1/2010
|
English
|
| Milwaukee Enrollment Services (MilES) Contact Poster - Hmong
|
P-00084H
|
Paper
|
1/1/2010
|
Hmong
|
| Milwaukee Enrollment Services (MilES) Contact Poster - Spanish
|
P-00084S
|
Paper
|
1/1/2010
|
Spanish
|
| Milwaukee Enrollment Services (MilES) Contact Poster Tear Off Sheets
|
P-00084A
|
Paper
|
1/1/2010
|
English
|
| Milwaukee Enrollment Services (MilES) Contact Poster Tear Off Sheets - Hmong
|
P-00084AH
|
Paper
|
1/1/2010
|
Hmong
|
| Milwaukee Enrollment Services (MilES) Key Contacts (PDF, 92 KB)
|
P-00087
|
PDF
|
12/1/2009
|
English
|
| Milwaukee Enrollment Services (MilES) Key Contacts - Hmong (PDF, 78 KB)
|
P-00087H
|
PDF
|
12/1/2009
|
Hmong
|
| Milwaukee Enrollment Services (MilES) Key Contacts - Spanish (PDF, 81 KB)
|
P-00087S
|
PDF
|
12/1/2009
|
Spanish
|
| Negative Notice
|
F-16001
|
Word
|
7/1/2008
|
English
|
| Negative Notice (PDF, 154 KB)
|
F-16001
|
PDF
|
7/1/2008
|
English
|
| Negative Notice - Spanish (PDF, 200 KB)
|
F-16001S
|
PDF
|
7/1/2008
|
Spanish
|
| Notice of Disqualification (PDF, 582 KB)
|
F-16024
|
PDF
|
7/1/2008
|
English
|
| Notice of Disqualification - Spanish (PDF, 867 KB)
|
F-16024S
|
PDF
|
7/1/2008
|
Spanish
|
| Notice of FoodShare Over issuance (PDF, 288 KB)
|
F-16028
|
PDF
|
7/1/2008
|
English
|
| Notice of FoodShare Overissuance - Spanish (PDF, 170 KB)
|
F-16028S
|
PDF
|
7/1/2008
|
Spanish
|
| Notice of Program Violation (PDF, 43 KB)
|
F-16014
|
PDF
|
7/1/2008
|
English
|
| Positive Notice
|
F-16015
|
Word
|
7/1/2008
|
English
|
| Positive Notice (PDF, 134 KB)
|
F-16015
|
PDF
|
7/1/2008
|
English
|
| Positive Notice - Spanish (PDF, 46 KB)
|
F-16015S
|
PDF
|
7/1/2008
|
Spanish
|
| Prosecution Diversion Agreement (PDF, 251 KB)
|
F-16026
|
PDF
|
7/1/2008
|
English
|
| Quality Assurance (QA) Sample Check List (PDF, 226 KB)
|
F-16011
|
PDF
|
7/1/2008
|
English
|
| Request for Replacement FoodShare Benefits (PDF, 17 KB)
|
F-00330
|
PDF
|
2/1/2012
|
English
|
| Self-Employment Income Report (PDF, 38 KB)
|
F-00107
|
PDF
|
4/1/2013
|
English
|
| Self-Employment Income Report (Worksheet) (PDF, 31 KB)
|
F-00107W
|
PDF
|
5/1/2010
|
English
|
| Self-Employment Income Report - Farmer (PDF, 80 KB)
|
F-00219
|
PDF
|
5/1/2010
|
English
|
| Self-Employment Income Report - Farmer (Worksheet) (PDF, 32 KB)
|
F-00219W
|
PDF
|
5/1/2010
|
English
|
| Self-Employment Income Report - Farmer - Hmong (PDF, 69 KB)
|
F-00219H
|
PDF
|
5/1/2010
|
Hmong
|
| Self-Employment Income Report - Farmer - Spanish (PDF, 81 KB)
|
F-00219S
|
PDF
|
5/1/2010
|
Spanish
|
| Self-Employment Income Report - Hmong (PDF, 29 KB)
|
F-00107H
|
PDF
|
4/1/2013
|
Hmong
|
| Self-Employment Income Report - Spanish (PDF, 29 KB)
|
F-00107S
|
PDF
|
4/1/2013
|
Spanish
|
| Self-Employment Income Worksheet - Corporation (PDF, 37 KB)
|
F-16034
|
PDF
|
2/1/2010
|
English
|
| Self-Employment Income Worksheet - Partnership (PDF, 49 KB)
|
F-16036
|
PDF
|
9/1/2012
|
English
|
| Self-Employment Income Worksheet - Sole Proprietor Farm and Other Business (PDF, 72 KB)
|
F-16037
|
PDF
|
9/1/2012
|
English
|
| Self-Employment Income Worksheet - Subchapter S Corporation (PDF, 60 KB)
|
F-16035
|
PDF
|
5/1/2009
|
English
|
| Social Security Number Referral (PDF, 61 KB)
|
F-16022
|
PDF
|
7/1/2008
|
English
|
| Social Security Number Referral - Hmong (PDF, 28 KB)
|
F-16022H
|
PDF
|
7/1/2008
|
Hmong
|
| Social Security Number Referral - Spanish (PDF, 26 KB)
|
F-16022S
|
PDF
|
7/1/2008
|
Spanish
|
| Striker Evaluation (PDF, 395 KB)
|
F-16023
|
PDF
|
7/1/2008
|
English
|
| Summary of Information Letter
|
F-00098
|
Word
|
6/1/2009
|
English
|
| Waiver of Administrative Disqualification Hearing (PDF, 61 KB)
|
F-16039
|
PDF
|
10/1/2011
|
English
|
| Waiver of Administrative Disqualification Hearing - Spanish (PDF, 75 KB)
|
F-16039S
|
PDF
|
10/1/2011
|
Spanish
|
| Wisconsin Medicaid Supplement to FoodShare Wisconsin Application (PDF, 86 KB)
|
F-10140
|
PDF
|
10/1/2012
|
English
|
| Wisconsin Medicaid Supplement to FoodShare Wisconsin Application - Spanish (PDF, 90 KB)
|
F-10140S
|
PDF
|
10/1/2012
|
Spanish
|
| Your Rights and Responsibilities for FoodShare (PDF, 103 KB)
|
F-10150B
|
PDF
|
10/1/2012
|
English
|
| Your Rights and Responsibilities for Health Care / FoodShare (PDF, 79 KB)
|
F-10150
|
PDF
|
10/1/2012
|
English
|
