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 of
health and human services to the entity designated by the department of health and human
services, 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 notification
to 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,
...................., D
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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 of
health and human services to the entity designated by the department of health and human
services, 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 notification
to 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 OF
EXECUTOR, AND
NOTICE TO CREDITORS
To the Department of Health and Human Services, Who May Be
Interested in the Estate of ...................., Deceased, who died on or
about ........................ (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...-...-.... The
name of the spouse is ........................ The birthdate of the spouse is
............ and the spouse’s social security number is...-...-...., and that
§633.304A, PROBATE CODE 70
the spouse of the deceased is alive as of the date of this notice, or
deceased 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 name
of ........................, who had a birthdate of ................ and a social
security number of...-...-...., and the medical assistance debt of
that medical assistance recipient was waived pursuant to section
249A.53, subsection 2, paragraph “a”, subparagraph (1), and is now
collectible from this estate pursuant to section 249A.53, subsection
2, paragraph “b”.
Notice is hereby given that if the department of health and
human services has a claim against the estate for the deceased
person or persons named in this notice, the claim shall be filed with
the clerk of the above-named district court, as provided by law,
duly authenticated, for allowance within six months from the date
of sending this notice and, unless otherwise allowed or paid, the
claim is thereafter forever barred. If the department does not have
a claim, the department shall return the notice to the executor with
notification that the department does not have a claim within six
months from the date of sending this notice.
Dated this ........ day of ............ (month), ............ (year)
........................
Executor of estate
................................
Address
........................
Attorney for executor
................................
Address