Form DHS-4574-B Assets Declaration Patient and Spouse - Michigan

Form DHS-4574-B Assets Declaration Patient and Spouse - Michigan

What Is Form DHS-4574-B?

This is a legal form that was released by the Michigan Department of Health and Human Services - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DHS-4574-B?
A: DHS-4574-B is a form for assets declaration for a patient and their spouse in Michigan.

Q: Who needs to fill out DHS-4574-B?
A: Patients and their spouses in Michigan need to fill out DHS-4574-B form to declare their assets.

Q: What is the purpose of DHS-4574-B?
A: The purpose of DHS-4574-B is to declare the assets of a patient and their spouse in Michigan for the purpose of healthcare eligibility.

Q: Is DHS-4574-B specific to Michigan?
A: Yes, DHS-4574-B is specific to Michigan and is used for assets declaration in the state.

Q: Is filling out DHS-4574-B mandatory?
A: Yes, patients and their spouses in Michigan are required to fill out DHS-4574-B form for assets declaration.

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Form Details:

  • Released on May 1, 2016;
  • The latest edition provided by the Michigan Department of Health and Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DHS-4574-B by clicking the link below or browse more documents and templates provided by the Michigan Department of Health and Human Services.

Download Form DHS-4574-B Assets Declaration Patient and Spouse - Michigan

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