Montana Title 53. Social Services and Institutions § 53-6-175. Recovery of medical assistance secured by lien--application for issuance of writ of execution

(a) the name of the recipient, a legal description of the real property, and a description of the recipient's interest in the property;

(b) a statement that the department has imposed a lien upon the property under 53-6-171;

(c) a statement that the lien complies with the requirements of 53-6-171 through 53-6-188;

(d) the date upon which the lien was filed and the office in which it was filed;

(e) a description of the sale, transfer, exchange, or other event that entitles the department to recover;

(f) a statement that the lien has not dissolved under 53-6-174(5);

(g) the amount of recoverable medical assistance; the amount of any unreimbursed taxes, insurance costs, maintenance costs, or other costs paid under 53-6-186; and, if applicable, a statement that additional amounts may be paid up to the time that the property is sold in satisfaction of the lien;

(h) a statement that the total amount due has not been paid as of the date of the application for the writ;

(i) a statement that recovery is not prohibited by this section;

(j) the names and addresses of all persons who have a recorded interest in the property, including a recipient or recipient's estate, co-owner, purchaser, grantee, encumbrancer, mortgagee, and lienholder; and

(k) a request that a writ of execution be issued for sale of the described property if an action is not filed within the time provided for in 53-6-177.