FA-4138: Income and Asset Statement - Wisconsin Court System - wicourts-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the name of the county where your case is filed, along with the case number and IV-D KIDS number if available.
3. In the 'Proof of Income' section, attach your current year income statement and most recent W-2 form.
4. Fill out your personal information under 'General Information', including your name, address, and phone number.
5. List all current household members in the designated section, indicating their relationship to you and whether they contribute to household expenses.
6. Calculate your monthly gross income by selecting how often you receive wages and using the provided multipliers. Fill in all sources of income.
7. Detail your monthly deductions such as taxes, insurance, and other payments. Sum these for total deductions.
8. Complete the 'Current Monthly Household Expenses' section by listing all relevant expenses and calculating total monthly expenses.
9. Indicate whether you have assets valued at $10,000 or more. Finally, sign and date the declaration at the bottom of the form.

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