Instructions for Form F-10111 Good Faith Certification - Wisconsin

Form F-10111 Good Faith Medicaid/Badgercare Plus Certification - Wisconsin

This document contains official instructions for Form F-10111 , Good Faith Certification - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-10111 is available for download through this link.

FAQ

Q: What is Form F-10111?
A: Form F-10111 is the Good Faith Certification form used in Wisconsin.

Q: What is the purpose of Form F-10111?
A: The purpose of Form F-10111 is to certify that a person or organization has made a good faith effort to meet the requirements of a specific program or regulation.

Q: Who needs to fill out Form F-10111?
A: Anyone who is required to demonstrate good faith compliance with a program or regulation in Wisconsin may need to fill out Form F-10111.

Q: What information is required on Form F-10111?
A: The specific information required on Form F-10111 may vary depending on the program or regulation it is being used for. However, it generally requires the individual or organization's name, contact information, and a detailed explanation of their good faith efforts.

Q: Is there a fee for filing Form F-10111?
A: No, there is no fee for filing Form F-10111.

Q: When is Form F-10111 due?
A: The due date for Form F-10111 may vary depending on the program or regulation it is being used for. It is important to check the specific requirements for the program or regulation.

Q: What should I do if I make an error on Form F-10111?
A: If you make an error on Form F-10111, you should contact the Wisconsin Department of Revenue for guidance on how to correct the mistake.

Q: Can I request an extension to file Form F-10111?
A: The ability to request an extension to file Form F-10111 may vary depending on the program or regulation it is being used for. It is important to check the specific requirements for the program or regulation.