Application —F-22571 (PDF, 288KB) — To apply for Caretaker Supplement benefits.
Fair Hearing Request (exit DHS) - To request a hearing if you don't agree with a decision about your benefits.
Fair Hearing Voluntary Withdrawal — DHA 17, (PDF 10KB) *(exit DHS) — If you want to withdraw your request for a hearing.
More information can be found at dhs.wisconsin.gov/ssi/caretaker.htm.
Agency Directory - To find the telephone number and address of your local agency.
Legal Services - To find the name and telephone number of who in your area can provide you with legal help. You may also go to:
Legal Action of Wisconsin, Inc. web site at http://www.legalaction.org/*(exit DHS), or
The Wisconsin Judicare, Inc. web site at www.judicare.org/ *(exit DHS).