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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 Language Available to order
F-10101PA Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, Pashto (PDF) 05/2026 Pashto No
F-10101H Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, Hmong (PDF) 05/2026 Hmong No
F-10101S Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, Spanish (PDF) 05/2026 Spanish No
F-10101DA Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, Dari (PDF) 05/2026 Dari (Afghan Persian) No
F-00107CM Self-Employment Income Report, Chinese (Simplified) (PDF) 05/2026 Chinese (Simplified) No
F-00107S Self-Employment Income Report, Spanish (PDF) 05/2026 Spanish No
F-00107 Self-Employment Income Report (PDF) 05/2026 English No
F-00107H Self-Employment Income Report, Hmong (PDF) 05/2026 Hmong No
F-00107AS Instructions, Self-Employment Income Report, Spanish (PDF) 04/2026 Spanish No
F-00107A Instructions, Self-Employment Income Report (PDF) 04/2026 English No
F-00107AH Instructions, Self-Employment Income Report, Hmong (PDF) 04/2026 Hmong No
F-00107ACM Instructions, Self-Employment Income Report, Chinese (Simplified) (PDF) 04/2026 Chinese (Simplified) No
F-16076 FoodShare Six-Month Report (Word) 04/2026 English No
F-16076S FoodShare Six-Month Report, Spanish (Word) 04/2026 Spanish No
F-16076H FoodShare Six-Month Report, Hmong (Word) 04/2026 Hmong No
F-16076AS FoodShare Six-Month Report Instructions, Spanish (Word) 04/2026 Spanish No
F-16076AH FoodShare Six-Month Report Instructions, Hmong (Word) 04/2026 Hmong No
F-16076A FoodShare Six-Month Report Instructions (Word) 04/2026 English No
F-00330G Request for Replacement FoodShare and/or Summer EBT Benefits, German (PDF) 04/2026 German No
F-00330 Request for Replacement FoodShare and/or Summer EBT Benefits (PDF) 04/2026 English No
F-00330R Request for Replacement FoodShare and/or Summer EBT Benefits, Russian (PDF) 04/2026 Russian No
F-00330S Request for Replacement FoodShare and/or Summer EBT Benefits, Spanish (PDF) 04/2026 Spanish No
F-00330SO Request for Replacement FoodShare and/or Summer EBT Benefits, Somali (PDF) 04/2026 Somali No
F-00330CM Request for Replacement FoodShare and/or Summer EBT Benefits, Chinese (Simplified) (PDF) 04/2026 Chinese (Simplified) No
F-00330AR Request for Replacement FoodShare and/or Summer EBT Benefits, Arabic (PDF) 04/2026 Arabic No

Glossary

 
Last revised February 20, 2026