Request for Verification
Document Number: DCF-F-DWSP2303
Description: This is a multiple program form for all the following services: Wisconsin Works (W-2), FoodShare (FS), Child Care assistance (cc) and Medicaid (MA). This form identifies the necessary information needed to complete the application to determine or re-determine eligibility for services. It is the responsibility of the program participant to provide required verification.
DCF-F-DWSP2303 (English Print Version - pdf/24 KB)
DCF-F-DWSP2303-H (Hmong Print Version - pdf/24 KB)
DCF-F-DWSP2303-S (Spanish Print Version - pdf/23 KB)
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