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This version of the form is not currently in use and is provided for reference only. Download this version of
Form F-40096
for the current year.
Form F-40096 Ewic Program Repayment Agreement - Wisconsin
What Is Form F-40096?
This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form F-40096?
A: Form F-40096 is the Ewic Program Repayment Agreement specific to Wisconsin.
Q: What is the Ewic Program?
A: The Ewic Program is a government program that provides electronic benefits for purchasing healthy foods.
Q: What is the purpose of the Repayment Agreement?
A: The Repayment Agreement is used to recover any overpayments made to participants in the Ewic Program.
Q: Who needs to fill out this form?
A: This form needs to be filled out by participants in the Ewic Program who have received overpayments.
Form Details:
- Released on February 1, 2018;
- The latest edition provided by the Wisconsin Department of Health Services;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form F-40096 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.
Download Form F-40096 Ewic Program Repayment Agreement - Wisconsin
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