633.304A Notice of probate of will — medical assistance claims. 1. On admission of a will to probate, the executor shall, in accordance with section 633.410, provide by electronic transmission on a form approved by the department ofhealth and human services to the entity designated by the department of health and humanservices, a notice of admission of the will to probate and of the appointment of the executor,which shall include a notice to file claims with the clerk or to provide electronic notificationto the executor that the department has no claim within six months of sending this notice,or thereafter be forever barred. 2. The notice shall be in substantially the following form: In the District Court of Iowa in and for .................... County. Probate No. ................ In the Estate of NOTICE OF PROBATE OF WILL, ...................., Deceased OF APPOINTMENT OFEXECUTOR, ANDNOTICE TO CREDITORS To the Department of Health and Human Services, Who May Be Interested in the Estate of ...................., Deceased, who died on orabout ........................ (date): You are hereby notified that on the ........ of Health and Human Services, Who May Be Interested in the Estate of ...................., Deceased, who died on orabout ........................ (date): You are hereby notified that on the ........ day of ............(month), ............(year), the last will and testament of ........................,deceased, bearing date of the ........ day of ............ (month), ............(year) was admitted to probate in the above-named court and that........................ was appointed executor of the estate. You are further notified that the birthdate of the deceased is ............ and the deceased’s social security number is...-...-.... Thename of the spouse is ........................ The birthdate of the spouse is............ and the spouse’s social security number is...-...-...., and thatthe spouse of the deceased is alive as of the date of this notice, ordeceased as of .................... (date). You are further notified that the deceased was/was not a disabled or a blind child of the medical assistance recipient by the nameof ........................, who had a birthdate of ................ You are further notified that the deceased was/was not a disabled or a blind child of the medical assistance recipient by the nameof ........................, who had a birthdate of ................ and a socialsecurity number of...-...-...., and the medical assistance debt ofthat medical assistance recipient was waived pursuant to section249A.53, subsection 2, paragraph 'a', subparagraph (1), and is nowcollectible from this estate pursuant to section 249A.53, subsection2, paragraph 'b'. Notice is hereby given that if the department of health and human services has a claim against the estate for the deceasedperson or persons named in this notice, the claim shall be filed withthe clerk of the above-named district court, as provided by law,duly authenticated, for allowance within six months from the dateof sending this notice and, unless otherwise allowed or paid, theclaim is thereafter forever barred. If the department does not havea claim, the department shall return the notice to the executor with Sat Dec 23 11:25:06 2023 Iowa Code 2024, Section 633.304A (56, 3) §633.304A, PROBATE CODE 2 notification that the department does not have a claim within sixmonths from the date of the executor with Sat Dec 23 11:25:06 2023 Iowa Code 2024, Section 633.304A (56, 3) §633.304A, PROBATE CODE 2 notification that the department does not have a claim within sixmonths from the date of sending this notice. Dated this ........ day of ............ (month), ............ (year) ........................Executor of estate................................Address........................Attorney for executor................................Address 2001 Acts, ch 109, §2; 2002 Acts, ch 1119, §99; 2007 Acts, ch 134, §13; 2010 Acts, ch 1137, §5; 2016 Acts, ch 1073, §174; 2023 Acts, ch 19, §1276 Referred to in §633.410, 635.13Section amended Sat Dec 23 11:25:06 2023 Iowa Code 2024, Section 633.304A (56, 3)
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