Confirm No Owner Role

Revised: May 3, 2024

Overview

Some organizations may not have owners, such as a nonprofit or a public entity, or may have multiple owners that own less than 5% of the organization. In the Confirm No Owner Role section of the Minnesota Provider Screening and Enrollment (MPSE) portal, enter your electronic signature and the current date to confirm that no person or business has five percent or more direct or indirect ownership or controlling interest in your organization.

Portfolio/Profile Information

See Portfolio/Profile Information on the Recurring Items page of the MPSE User Manual.

Confirm No Owner Role

Read the statement in this section and use the Enter your name field and the Signature Date field to agree to the statement. Click Continue to save the information or click Cancel to go back to the Manage Owners/Authorized Persons page.

Enter your name

Type your full legal name in the Enter Your Name box in the format of first name, middle name, last name.

Enter the date

Enter today’s date in the Enter the Date box in the format of MM/DD/YYYY.

Continue

Click Continue to save your changes and go to the next page.

Cancel

Click Cancel to go back to the previous page.