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Wisconsin Income Expense Statement

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INCOME & EXPENSE STATEMENT

PRINT in BLACK ink

STATE OF WISCONSIN, CIRCUIT COURT,

COUNTY

This form is used for divorce, legal separation and paternity cases. Some information may not apply to your case.

For Official Use

Case No.

IV-D KIDS Case No.

Failure by either party to complete and file this form as required will authorize the court to accept the statement of the other party as the basis for its decisions. Deliberate failure to provide complete disclosure is a crime. Attach additional pages if space is not sufficient.

1. PROOF OF INCOME

▪ Attach a statement reflecting income earned to date for the current year.

▪ Attach most recent W-2 Statement.

2. GENERAL INFORMATION

Name

Address

Address

City State Zip

Phone (day)

3. CURRENT MEMBERS OF YOUR HOUSEHOLD

Enter the name and relationship of all people actually living in your household at this time. Check yes or no to identify if they contribute to payment of household expenses.

Name Relationship I live alone This person helps pay expenses - Yes No
1.
2.
3.
4.

4. MONTHLY INCOME

Income from wages / salary is received (check one): To calculate monthly gross income use the multiplier shown: weekly - multiply weekly income by 4.3 every other week (bi-weekly) - multiply bi-weekly income by 2.15 monthly twice a month - multiply semi-monthly income by 2

MONTHLY GROSS INCOME Amount
1. Gross monthly income (before taxes and deductions) from salary and wages, including commissions, allowances and overtime.
2. Pensions, retirement funds and social security benefits received
3. Disability, Unemployment Insurance and/or public assistance funds received
4. Interest and Dividends received
5. Child Support and maintenance (spousal support) received
6. Rental payments received (from property you rent to others)
7. Bonuses received
8. Other sources of income received: (please specify)
9.
10. Total Gross Income (add lines 1-9)

MONTHLY DEDUCTIONS

11. Number of tax exemptions claimed
12. Monthly federal and state income tax, Social Security, and Medicare withholdings
13. Medical insurance
14. Other insurance (Life, disability, etc.)
15. Union or other dues
16. Retirement, pension and/or deferred compensation fund
17. Child support or spousal support payment deductions
18. Other deductions: (please specify)
19.
20.
21. Total Monthly Deductions (add lines 12 – 20)
MONTHLY NET INCOME (subtract line 21 from line 10)

5. CURRENT MONTHLY HOUSEHOLD EXPENSES

Monthly Household ExpensesAmount
1. Rent/mortgage payment/property taxes/home or rent insurance (primary residence)
2. Food
3. Utilities (electricity, heat, water, sewage, trash)
4. Telephone (local, long distance & cellular)
5. Cable/Satellite and Internet Services
6. Insurance (life, health, accident, auto, liability, disability, excluding insurance that is paid through payroll deductions)
7. Auto payments (loans/leases), auto expenses (gas, oil, repairs, maintenance), and transportation (other than automobile)
8. Medical, dental and prescription drug expenses (not covered by insurance)
9. Childcare (babysitting and day care)
10. Child support or spousal support payments (Exclude payments made through payroll deductions)
11. Other expenses
Other Monthly installment payments:
12. Mortgage (other than primary mortgage)
13. Other vehicle payments (RV, boat, ATV)
14. Credit card debt (total minimum monthly payments)
15. Court ordered obligations
16. Student loans
17. Other personal loans
18.
TOTAL MONTHLY EXPENSES (Add lines 1-18)

6. I do do not have assets (vehicles, real estate, personal property, stocks, retirement accounts, etc) with a total fair market value of $10,000 or more at this time.

7. DECLARATION: I declare under penalty of perjury that the above, including all attachments, is true and correct as of the date signed below.

Sign and print your name. Enter the date on which you signed your name. Note: This signature does not need to be notarized.

Signature

Print or Type Name

Date

Enter text✕
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What the Wisconsin Income Expense Statement Is and when it's used

The Wisconsin Income Expense Statement is a standardized financial summary used to report income and operating costs for a specific property or business for a defined reporting period. Commonly completed by property owners, managers, and small-business operators, the form aggregates gross receipts, itemized operating expenses, and calculated net operating income. Recipients include lenders, accountants, tax preparers, and potential buyers; the statement supports underwriting, tax preparation, valuation, and budgeting. The document may be submitted electronically or as a printed record and is often paired with supporting schedules and receipts for verification purposes.

Why a clear Income Expense Statement matters

A concise Wisconsin Income Expense Statement standardizes financial disclosure, simplifies underwriting and tax review, and provides a single source of truth for income and expense totals used in decision-making.

Why a clear Income Expense Statement matters

Common users and recipients of this statement

Who prepares and relies on the statement in typical transactions.

  • Property owners and landlords who track rental revenue, operating expenses, and cash flow for specific properties.
  • Lenders and mortgage underwriters that use the statement to assess debt service coverage and loan eligibility.
  • Accountants and tax preparers who reconcile reported figures with tax returns and supporting records.

Use clear, consistent reporting to reduce review time for lenders, accountants, and buyers.

Step-by-step: completing the statement accurately

Use this sequence to prepare a complete Wisconsin Income Expense Statement for lenders, tax prep, or internal records.

  • 01
    Gather Documents: Collect leases, rent rolls, bank statements, and invoices for the reporting period.
  • 02
    Populate Identification: Enter owner/entity name, property address, and the reporting period first.
  • 03
    Enter Income & Expenses: Record gross receipts then itemize operating expenses with supporting totals.
  • 04
    Sign and Assemble: Sign the statement, attach schedules, and produce one compiled file for reviewers.

How to configure an online version for repeated use

Set up a reusable template with key fields, authentication, and routing to speed future submissions.

Field Configuration
Document Type PDF or DOCX template with locked calculation fields
Authentication Email verification or SMS code for signer identity
Conditional Fields Show attachment upload only if expenses > threshold
Audit Trail Capture timestamps, IP, and signer email automatically

What a professional Wisconsin Income Expense Statement includes

A complete statement combines identification, detailed income lines, categorized expenses, computed metrics, and supporting attachments so reviewers can verify and rely on the numbers.

Identification

Owner name, property address, reporting period and contact details so reviewers know which asset the numbers represent.

Income Section

Line items for rent, vacancy adjustments, reimbursements, and other revenue streams with gross totals.

Expense Categories

Break out repairs, utilities, taxes, insurance, management fees, and other operating expenses for transparency.

NOI / Cash Flow

Net operating income and cash flow calculations showing profitability before debt service and capital expenditures.

Supporting Schedules

Attach rent rolls, invoices, and lease abstracts to substantiate major lines and unusual items.

Certification

Signature block and a short declaration that figures are true, accurate, and complete to the signer’s knowledge.

Required core data elements at a glance

Owner Name: Legal entity
Property Address: Street and ZIP
Reporting Period: MM/DD/YYYY
Gross Income: Total receipts
Total Expenses: Sum of categories
Signer Certification: Signed and dated

Where to send the completed statement

Select the appropriate recipient and method based on the statement’s purpose—lending, tax filing, or internal records.

  • Lender Submission: Attach to loan application package or upload to lender portal.
  • Tax Preparation: Provide to your accountant with supporting receipts and schedules.
  • Property Management: Store in property folder and share with stakeholders as needed.
  • Prospective Buyer: Include in due diligence data room with verifiable attachments.

Technical formats and integration points for digital use

Use PDF or DOCX templates and standard integrations to streamline collection and storage of signed statements.

  • File Formats: PDF, Word DOCX, Excel
  • Integrations: Salesforce, NetSuite, Google Workspace, Microsoft 365
  • Authentication: Email verification and optional SMS/KBA

Representative eSignature vendor comparison for document signing

A concise pricing and capability snapshot for common eSignature vendors. signNow appears first per platform comparison conventions.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes

Consequences of inaccurate or incomplete statements

Tax Penalties: IRC §6721 fines possible
Loan Denial: Underwriting may reject the application
Audit Exposure: Increased risk during tax audits
Repayments Risk: Lender may require immediate remedies
Compliance Gaps: Missing supporting docs flagged
Reputational Harm: Trust with stakeholders erodes

Common mistakes to avoid when preparing the statement

  • Failing to attach supporting schedules and receipts, which slows verification and increases credential requests from lenders.
  • Mixing personal and property expenses, causing incorrect expense totals and potential tax adjustments or disallowances.
  • Using inconsistent reporting periods or mismatched dates between income and expense items, resulting in reconciliation errors.
  • Submitting unsigned or undated statements, which many recipients consider incomplete and may return for re-signing.

Timing considerations and typical deadlines

Be aware of internal and external deadlines tied to loans, tax filings, or closing dates when preparing or submitting the statement.

Lender Requests:

Provide within 3–10 business days of request by typical underwriting standards

Tax Preparation:

Deliver to tax preparer before individual or business tax filing deadlines

Sale or Closing:

Include with due diligence materials at contractually required delivery dates

Annual Records:

Reconcile and store annually with bookkeeping close

Correction Window:

Respond to reviewer questions within 5–7 business days to avoid application delays

Key milestones from preparation to final submission

Sequence the preparation and delivery steps so reviewers receive a complete, verifiable package on time.

01

Document Collection

Gather source records and invoices for the reporting period.

02

Draft Completion

Populate the form with summarized income and expense lines.

03

Internal Review

Reconcile totals and attach supporting schedules; correct discrepancies.

04

Delivery and Signing

Send to recipient with signatures and required authentication.

Frequently asked questions about the Wisconsin Income Expense Statement

Answers to common questions about completion, signature methods, retention, and what recipients typically request.


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