Get Mn Family Systems License Application 2017-2025

The MN Family Systems License Application is a vital document for individuals and organizations seeking licensing for various family support services in Minnesota. This guide provides a clear and supportive breakdown of how to accurately complete the application online, ensuring all necessary information is effectively communicated.

Follow the steps to complete your application smoothly.

1. Click the ‘Get Form’ button to access the MN Family Systems License Application and open it in the editor.
2. Begin by entering the date of your application at the top of the form. Use black or blue ink if filling it out physically, but if online, ensure the date format is correct.
3. Select the license type you are applying for by checking all applicable boxes. Options include Corporate Adult Foster Care, Community Residential Setting, Family Adult Day Services, or Alternate Overnight Supervision Technology.
4. Indicate whether this application is for a new license, renewal, update, or change of premise by marking the appropriate box.
5. Fill in the program name and physical location. Provide a full street address, and if necessary, include a PO Box for mail delivery. Ensure that the telephone number, city, county, and ZIP code are accurately completed.
6. Complete the license history section by indicating whether you have ever been licensed and providing details of past licenses if applicable.
7. Provide the required information regarding the license holder. Clearly indicate if the holder is an individual or a nonindividual and include all relevant identification, including tax details.
8. Input the primary business address for the license holder, along with additional details about any co-applicants if applicable.
9. Identify and provide information about controlling individuals associated with your application. This includes their roles, ownership percentages, and contact details.
10. Designate an authorized agent, including their name and email address, if required, especially for new applications without an entity ID.
11. Provide dwelling information relevant to the program location. Select all applicable housing types and check all relevant boxes.
12. If applicable, complete the section for individuals living in the program, detailing their names, relationships, and birth dates.
13. As required, list references for initial licensing if applying for certain programs, detailing their contact information.
14. For AFC and CRS applicants, fill in the population served section, indicating the number of individuals and their specific needs.
15. Complete any sections required by your specific application, such as hours of operation for FADS or specific requirements for alternate overnight supervision technology.
16. Document your contact with the municipality regarding local ordinance requirements.
17. Verify compliance with workers’ compensation insurance by submitting the necessary Certificate with your application.
18. Acknowledge the public funding reimbursement option and select whether you elect to receive it.
19. Finally, review the entire application for accuracy and completeness before signing and submitting your application.
20. Once completed, ensure to save changes, download, print, or share the form as needed.

Complete your MN Family Systems License Application online today to ensure timely processing and compliance.