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Title 8: Medicaid Page 3 Iowa Department of Health and Human Services Employees’ Manual Chapter B: Application Processing Filing a Medicaid Application Revised October 17, 2025 Who Must Sign the Application Who Must Sign the Application Legal reference: 42 CFR 435.907 and 435.909, 441 IAC 76 (Rules in Process) and 76.9 To be considered a valid application, an application must have the following:  A legible name,  An address, and  A signature under penalty of perjury. Before eligibility can be approved, the application form must be signed by:  The applicant (including a child living independently), or  An adult in the applicant’s household or family, including: • A spouse, • A parent of an applicant child, including either parent of an unborn child, • A non-parental caretaker of an applicant child, • A tax-filer who claims the applicant as a dependent  A responsible person acting on behalf of a minor applicant or an incompetent, incapacitated, or deceased applicant, such as: • A guardian or conservator, • A friend or relative with knowledge of the applicant’s circumstances, or • A person or organization that has signed form 470-3356, Inability to Find a Responsible Person.  An authorized representative. If an authorized representative signs the application on behalf of the applicant, the signature of the applicant or responsible person must be on the application before eligibility can be approved. See Representation. NOTE: If the applicant is under a guardianship or conservatorship that was established voluntarily, the applicant may sign the application. When a person voluntarily asks the court to appoint a guardian or conservator, the court may do so without making a determination that the person is incompetent. Applications that are filed electronically, whether signed and faxed or scanned and e-mailed, do not have to be signed again.