All Income Maintenance (IM) Forms and Worksheets

Below is a list of all Income Maintenance (IM) forms and worksheets.

When you are searching for a document, enter the number or a portion of the title in the search box below.

Assigned number	Title	Release date Sort ascending	File type	Language	Available to order
F-10101DA	Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, Dari	05/2026	PDF	Dari (Afghan Persian)	No
F-10101H	Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, Hmong	05/2026	PDF	Hmong	No
F-10101PA	Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, Pashto	05/2026	PDF	Pashto	No
F-10101	Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet	05/2026	PDF	English	Yes
F-10101S	Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, Spanish	05/2026	PDF	Spanish	No
F-00107H	Self-Employment Income Report, Hmong	05/2026	PDF	Hmong	No
F-00107CM	Self-Employment Income Report, Chinese (Simplified)	05/2026	PDF	Chinese (Simplified)	No
F-00107S	Self-Employment Income Report, Spanish	05/2026	PDF	Spanish	No
F-00107	Self-Employment Income Report	05/2026	PDF	English	No
F-00107AS	Instructions, Self-Employment Income Report, Spanish	04/2026	PDF	Spanish	No
F-00107A	Instructions, Self-Employment Income Report	04/2026	PDF	English	No
F-00107AH	Instructions, Self-Employment Income Report, Hmong	04/2026	PDF	Hmong	No
F-00107ACM	Instructions, Self-Employment Income Report, Chinese (Simplified)	04/2026	PDF	Chinese (Simplified)	No
F-16076	FoodShare Six-Month Report	04/2026	Word	English	No
F-16076A	FoodShare Six-Month Report Instructions	04/2026	Word	English	No
F-16076AH	FoodShare Six-Month Report Instructions, Hmong	04/2026	Word	Hmong	No
F-16076AS	FoodShare Six-Month Report Instructions, Spanish	04/2026	Word	Spanish	No
F-16076S	FoodShare Six-Month Report, Spanish	04/2026	Word	Spanish	No
F-16076H	FoodShare Six-Month Report, Hmong	04/2026	Word	Hmong	No
F-00330G	Request for Replacement FoodShare and/or Summer EBT Benefits, German	04/2026	PDF	German	No
F-00330AR	Request for Replacement FoodShare and/or Summer EBT Benefits, Arabic	04/2026	PDF	Arabic	No
F-00330H	Request for Replacement FoodShare and/or Summer EBT Benefits, Hmong	04/2026	PDF	Hmong	No
F-00330CM	Request for Replacement FoodShare and/or Summer EBT Benefits, Chinese (Simplified)	04/2026	PDF	Chinese (Simplified)	No
F-00330L	Request for Replacement FoodShare and/or Summer EBT Benefits, Laotian	04/2026	PDF	Lao	No
F-00330S	Request for Replacement FoodShare and/or Summer EBT Benefits, Spanish	04/2026	PDF	Spanish	No

Glossary