SI CHI01801.002 Wisconsin Foodshare (RTN 406 -- 04/2007)


A. Program Description


The purpose of the FoodShare Program is to end hunger and improve nutrition and health. It helps low-income households buy the food they need for a nutritionally adequate diet. In Wisconsin, local county and tribal offices administer the program, and the Federal Government oversees the State operation.


B. Who May Be Eligible For FoodShare


Generally, individuals or families who are eligible for FoodShare are employed but do not make enough money to completely support their families, or are disabled and cannot work, or have lost their jobs, or are living on small, fixed incomes. This may include:


  • Low-income workers,

  • W-2 Participants,

  • Elderly or disabled persons,

  • Individuals with high housing and utility costs, or

  • Individuals who pass both the gross income and asset test for eligibility.


C. Spending FoodShare


FoodShare benefits can only be used for food and for plants and seeds to grow food for the household to eat. Sales tax cannot be charged on items bought with FoodShares.


FoodShare benefits cannot be used to buy:


  • Any non-food item, such as pet foods; soaps, paper products, and household supplies; grooming items, toothpaste, and cosmetics,

  • Alcoholic beverages and tobacco,

  • Vitamins and medicines,

  • Any food that will be eaten in the store, or

  • Food that is hot at the point of sale.


D. Electronic Benefit Transfer


FoodShare benefits are issued on a debit-type card. The Wisconsin QUEST card allows FoodShare clients to access their benefits through point-of-sale terminals at participating food stores. These transactions look like any other debit card transaction and are free to the client.


E. FoodShare Questions for SSI Claimants


Two FoodShare questions must be asked when completing either a SSI application or redetermination. The two questions are:


  • Are you currently receiving FoodShare or has a FoodShare application been filed for you within the past 60 days on which there has not been a decision?

  • If "No," do you wish to apply for FoodShare?

The responses to the questions are used to help determine whether to take no further action in connection with eligibility for FoodShare benefits, to take an application for FoodShare benefits, or to refer the claimant to the county/tribal agency to apply for FoodShare.


The FoodShare questions are included on the SSA-8000BK, SSA-8203BK, and SSA-8202F6. The questions are not contained on the SSA-8202-OCR. SI 02305.809 indicates that the FoodShare questions should not be asked when a SSA-8202-OCR is completed without SSA staff assistance. However, when a SSA-8202-OCR is completed by phone or the claimant contacts the district/branch office for assistance, use the preprinted SSA-795 (Statement of Claimant or Other Person) which contains the questions.


F. State of Wisconsin FoodShare Application


The State of Wisconsin FoodShare Application Form (HCF 16019B) is designed to collect information to determine household eligibility for FoodShare benefits. Most questions require "Yes" or "No" answers. If the applicant does not know the answer to a question, enter a question mark (?) to let the FoodShare worker know further information is needed.


The HCF 16019B can be completed by and/or for households eligible to file for FoodShare at a SSA office under joint processing procedures (SI 01801.005). If a member of the public who is not eligible to file for FoodShare in a SSA office (e.g., not a member of a pure SSI household) indicates a desire to file for FoodShare benefits; the individual should be referred to the local county/tribal office.


The form (HCF 16019B) used by SSA field offices to obtain FoodShare assistance in the State of Wisconsin has been revised. The new revised form has been slightly modified from the original version. A supply of the new form can be obtained from the local county/tribal offices. A copy of the form is also available on the state’s website at


1. Application/Recertification Process


When a SSI applicant and/or recipient files for FoodShare in a SSA office, the SSA interviewer will complete the application. Wisconsin uses the same application for recertification that is used in the initial certification of FoodShare eligibility. In completing the application, the SSA interviewer should answer the questions as the FoodShare applicant would if they were filling out the form. The interviewer will accept the applicant's allegation unless the information provided is questionable or verification of an item is required (SI 01801.300).


2. Page 1 - Wisconsin FoodShare Only Application - Registration - Exhibit I


Complete the front page with information regarding the applicant. Be sure to include a phone number where the applicant may be reached during normal working hours. If the applicant does not have a residence street address, write in sufficient information to find the applicant.


3. Page 2 - Expedited Service


The information on this page will be used by the county/tribal agency to determine if the applicant qualifies for expedited processing of the FoodShare application (SI 01801.150). All of the information needed for an expedited service determination is listed on this page.


4. Page 3 - 8 - Important Information


These pages include information about FoodShare benefits, completing the application process, and applicant rights and responsibilities. Review this information with the individual. These pages are to be given to the applicant to keep.


G. Wisconsin FoodShare Only Application – Exhibit II


1. Page 1


Complete Section I with information about the SSA office that accepts the application and record the date the application was completed. The local FoodShare agency will assign the case name and number when the FoodShare eligibility worker processes the application.


Section II & III captures information about the person helping the applicant complete the application and the applicant.


2. Page 2


Section IV captures information about the applicant’s household composition and identifying information.


Section V captures information about household members’ student status.


3. Page 3


Section VI captures other non-financial information.


Section VII captures information about the absent parent(s) of minor household members.


4. Page 5


Section VIII captures information about assets. This information is not needed for SSI recipients.


Section IX captures information about employment and earned income. All sources of income must be listed on the FoodShare application. Request that the applicant submit verification of all monthly income. It is not necessary to send copies of documents that are available in SSA files to the FoodShare office. Annotating the SSA-4233 (Social Security Administration Transmittal for FoodShare Applications) (SI 01801.310) that evidence is in SSA files will satisfy the documentation requirement.


Section X captures information about any loss of employment.


5. Page 6


Section XI captures information about unearned income, including SSI or other social security benefits. All sources of income must be listed on the FoodShare application. Request that the applicant submit verification of all monthly income. It is not necessary to send copies of documents that are available in SSA files to the FoodShare office. Annotating the SSA-4233 (Social Security Administration Transmittal for FoodShare Applications) (SI 01801.310) that evidence is in SSA files will satisfy the documentation requirement.


Section XII captures information about the household’s childcare, child support payment, medical, shelter, and utility expenses. These questions determine if any household members have these expenses, the nature of the expenses and whether anyone in the household has private health or hospital insurance. Forward any proof of expenses submitted by the individual to the county/tribal agency.


6. Page 7


Section XIII informs the applicant about rights and responsibilities. Review the information with the applicant. The applicant or an authorized representative must sign the application.


7. Page 8 - 9


Notes regarding the applicant and information included in the application may be recorded on these pages.


H. FoodShare Benefits


The Wisconsin FoodShare Application is an application for FoodShare benefits only. FoodShare benefits are available to low-income households to help them meet monthly nutritional needs. A household is usually made up of the people who live together and share food. The amount of the FoodShare benefit is based on the household's income and the number of people in the household. FoodShare benefits are issued through the Wisconsin QUEST card that is used like a debit card at participating grocery stores or other participating food retailers. The members of a household who receive FoodShare benefits are called the FoodShare group.


I. Completing the Application Process


To complete the application process for FoodShare an individual will be required to have an interview with a FoodShare or Supplemental Security Income (SSI) eligibility worker. They will be asked to provide information that is needed to determine their household's eligibility for FoodShare. They will also be asked to provide proof of certain information, such as:


  • Identity

  • Citizenship or Immigration Status

  • Address

  • Monthly Goss Income (before taxes)


To receive a deduction for the following expenses they must report and verify:


  • Rent or mortgage payments

  • Utility costs

  • Dependent care expenses

  • Legally-obligated child support payments

  • Out-of-pocket medical expenses for any elderly or disabled household member


J. Priority Service


An applicant may be eligible to receive faster service if their household:


  • Has no more that $100 available in cash and bank accounts and expects to receive less than $150 in income this month; OR

  • Has total monthly gross income and available cash and bank accounts that is less than the rent, mortgage, and utility costs for this month; OR

  • Includes a migrant or seasonal farm worker household


To see if an individual is eligible to receive FoodShare within seven days, they must answer the questions on the back of the FoodShare Registration form and sign the front of the form. The completed FoodShare Registration form should be submitted to their local county/tribal social or human services department.


K. Authorized Representative


Individuals applying for FoodShare have the right to have another person represent them and act on their behalf to complete the application process.


L. Use of Social Security Numbers/Personally Identifiable Information


Personally identifiable information will only be used for the direct administration of FoodShare in Wisconsin.


M. Immigration Status


To be eligible for FoodShare benefits an individual must be a U.S. citizen or have a qualifying immigration status with the United States Citizenship and Immigration Services (USCIS). The immigration status of any person applying for FoodShare benefits will be verified with the USCIS. Information from USCIS may affect FoodShare eligibility and benefit amount.


Immigration status will NOT be verified with USCIS for persons who are not requesting assistance or who indicate that they do not have a qualifying immigration status with INS. However, the income and assets belonging to these individuals may affect FoodShare eligibility and benefit amount.


N. W-2 Eligibility


The FoodShare Program is an entitlement. An individual do not have to apply for W-2 to be eligible for FoodShare benefits.


O. Change Reporting Requirements


If an applicant is found eligible for FoodShare benefits, they must report some household changes to their county/tribal social or human services department within ten days if the live in a household with all elderly, blind or disabled individuals and they have no earned income. Failure to report a reduction or loss of income will mean that they do not want the resulting increase in FoodShare benefits.


P. Work Registration


All persons in an individual’s FoodShare group must be registered with the FoodShare Employment and Training program, unless otherwise exempt.


Q. Time-Limited Benefits


Adults 18-49 years of age who are not living with dependent children may be subject to time limited FoodShare benefits unless they meet certain criteria established by the local county/tribal agency.


R. Student Eligibility


Students 18-49 years of age enrolled half-time or more in an institution of higher education such as a university, vocational, or technical college, are ineligible for FoodShare benefits unless they meet certain requirements established by the local county/tribal agency.


S. Child Support Cooperation


While an individual is receiving FoodShare benefits they must cooperate with the child support agency to establish paternity or to secure and enforce a child support order for their child(ren) under 18 years of age. If they do not cooperate with the child support agency their benefits may end or be reduced.


T. Documentation


Applicants should be encouraged to provide proof of their residence, income and expenses, which will expedite the process. It is not necessary to send copies of documents that are available in SSA files to the food stamp office. Annotating the SSA-4233 (Social Security Administration Transmittal for Food Support Applications) (SI 01801.310) that evidence is in SSA files will satisfy the documentation requirement.


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SI CHI01801.002 - Wisconsin Foodshare (RTN 406 -- 04/2007) - 10/05/2022
Batch run: 10/05/2022