The Minnesota Notarized form is an essential document designed to ensure compliance with state regulations, particularly for individuals and organizations seeking to obtain or maintain a license through the Minnesota Department of Human Services. This form requires the notarized signature of the applicant, which is a critical step mandated by Minnesota Statutes 2012, section 245A.04, subdivision 1. For individual license holders, this means that the person operating the license must personally sign the form. Conversely, nonindividual license holders must have an authorized agent sign on their behalf, who will manage all interactions with the commissioner of human services. The form collects vital information, including the license holder's full legal name, address, and tax identification numbers, ensuring that all details are accurate and up to date. Instructions are provided to guide applicants through the process, emphasizing the importance of signing the form in the presence of a notary public, who will verify the identity of the signer. This verification step is crucial, as it adds a layer of authenticity to the application, helping to prevent fraud. Once completed, applicants are advised to retain a copy of the notarized form for their records while mailing the original to the designated address by the specified deadline. Understanding these components is vital for anyone navigating the licensing process in Minnesota, as compliance with these requirements can significantly impact the ability to operate legally within the state.