SeniorCare Application Instructions, F-10076A - Wisconsin - dhs wisconsin 2025

1. Click ‘Get Form’ to open the SeniorCare Application Instructions in the editor.
2. Begin by filling out Section I and II with your personal information. Ensure you provide details for both yourself and your spouse if applicable, using clear capital letters.
3. In Section III, enter your mailing address accurately. Indicate whether this is your residence or a representative's address.
4. Proceed to Section IV to estimate your expected annual income. Carefully round amounts to the nearest dollar and include all relevant income types as specified.
5. Sign the application in Section V. Remember, forms without a signature will be returned.
6. Finally, enclose the correct enrollment fee as indicated in Section VI and submit your completed application through our platform for efficient processing.

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