Get Application For Certificate Of Clearance For ... - Minnesota Cle - Minncle

This guide provides step-by-step instructions on filling out the Application For Certificate Of Clearance For Medical Assistance Claim in Minnesota. It is designed to assist users, regardless of their legal experience, in completing the form accurately and efficiently.

Follow the steps to successfully complete your application

1. Press the ‘Get Form’ button to access the application and open it in the online editor.
2. Enter the relevant details in the first section: This includes the county's name where the application is being filed and the name of the County Agency responsible for handling the request.
3. In the second section, provide the petitioner’s name and specify the district court information, including the case caption and case number for reference.
4. Indicate your role in the case by selecting whether you are the petitioner or the attorney for the petitioner. Strike through the incorrect option to clarify your position.
5. Fill out the decedent’s full name and their date of birth in the specified fields.
6. List the full names and dates of birth for any predeceased spouses of the decedent, as required.
7. Provide detailed information about the heirs and devisees, including their names, addresses, and telephone numbers. If necessary, attach additional sheets for more entries.
8. Attach a copy of the notice of hearing as mentioned in Minnesota Statutes, section 525.312, ensuring it is referenced as part of your application.
9. Date the application and include your signature, along with the printed name of the petitioner or attorney for the petitioner, and any necessary contact information.
10. Finally, save your changes, and choose to download, print, or share the completed form as needed.

Complete your application for the certificate of clearance online today.