NEW Income Eligibility Documents (CC, HS, OS, ADC, FDCH)
As of July 1, 2025, start using the Household Size Income Statement (FFY 2026, Rev. 6/25), Household Letter (FFY 2026, Rev. 6/25), and Household Size Income Scale (July 1, 2025 - June 30, 2026).
These documents are now posted on the Guidance Memorandum (GM) web page under GM 1 and GM I (for FDCH sponsors).
Distribute the HSIS and Household Letter (FFY 2026, Rev. 6/25) to:
- Newly enrolling participants.
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Enrolled participants when their current form expires: The FFY 2026, Rev. 6/25 HSIS does not have to be completed by participants who have current and valid HSIS on file until their current form expires. At that time, provide these households with a FFY 2026, Rev. 6/25 Household Letter and HSIS.
Discard all previous FFY Household Letters and blank HSISs (with revision dates of 6/24 or earlier) on hand and replace them with FFY 2026, Rev 6/25 versions. This includes copies that are in enrollment packets.
Inform all pertinent staff to distribute the FFY 2026 (6/25 revision) Household Letter and HSIS to new enrollees and current participants when their HSIS form expires, and to use the Household Size-Income Scale (July 1, 2025 - June 30, 2026) for determining eligibility.
The Household Letter and HSIS must be distributed to households of all enrolled participants.
These Household Size Income Statements and Household Letters will be translated into Spanish and Hmong at a later date and shared in a future CACFP Bulletin.
Household Size Income Statement (HSIS) Reminders
Household Size Income Statements (HSIS) are to be completed by a member of the participant’s family/household.
- They are not to be completed, whole or in part, or revised by an agency.
- If a household returns an incomplete HSIS, first reach out to the household to have them add missing information to the HSIS. If the agency must contact the household to clarify information, with the exception of the household member’s signature and signature date, programs may obtain information by phone, email, or text. After obtaining missing information, note the following on the HSIS:
- Information obtained
- From whom the information was received
- Date information was received
- Determining Official (DO) initials
Part 1: Benefits Reminders:
- Quest Card numbers cannot be accepted as a valid case number for FoodShare Wisconsin. When a household reports the 16-digit Quest Card number or a number that begins with 5077 for FoodShare Wisconsin, the HSIS must not be determined as Free. The household must be contacted to obtain the 10-digit FoodShare case number.
- Wisconsin Shares Child Care subsidy benefits do not qualify participants as Free.
Refer to GM 1 or GM I (FDCH sponsors) for more information about determining and approving HSIS.
Income Eligibility Calculator
The Income Eligibility Calculator may be used to calculate the total reported household income and determine the household’s eligibility (Free, Reduced, Non-needy). Simply enter the income reported on the HSIS and it will show the total annual income and eligibility determination for the reported number of household members. Use this information to complete the For Center Use Only box on the HSIS. This resource can be found on the Guidance Memorandum (GM) webpages under GM 1 and GM I (FDCH sponsors).
Updated Wisconsin WIC Program Information Sheet (CC, HS, FDCH)
The updated Wisconsin WIC Program Information Sheet is posted on the Guidance Memorandum (GM) webpages under GM 9 and GM K (FDCH sponsors).
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