Section 144-298-3 - APPLICATION PROCESSA.Application form. An applicant must submit a completed Department-approved application form. The applicable tax year application forms are available on the Department's publicly accessible website: https://www.maine.gov/dhhs/mecdc/public-health-systems/rhpc/. Upon request, a paper copy is mailed to the applicant.B.Method of submission. Applicants must mail their applications by U.S. Mail, postage prepaid, to the address listed on the application form.C.Complete, timely application required. During the review process, the Department will consider only complete applications that are postmarked within the time-limited period established in Section 3(E). Incomplete applications will not be included in the review process.D.Complete applications. To be considered complete, an application must comply with the following requirements. 1. Application form required. The application form must be signed and dated by the applicant and include all requested information. Each application must be postal mailed in a separate envelope. Multiple applications mailed in a single envelope are not included in the Department's review process.2. Required documents. Complete applications must include copies of the following documents. b. Practice location in underserved area. Proof that the applicant's practice location is in an underserved area. Acceptable documents include a copy of incorporation documents, partnership agreements, an employer identification number (EIN), or a federal or State tax form that includes the street address, city, state, and ZIP code of the specific geographic location where the professional practices full-time within their scope of practice.c. Student loan. A copy of the promissory note, loan statement or similar document acceptable to the department showing an unpaid qualified student loan balance.d. First year certification. With an initial application, documentation must be submitted demonstrating the applicant meets the conditions of eligibility for at least six months of the first tax year for which the applicant applies for certification for a tax credit as described in 36 M.R.S. §5219-LL(2)(A).E.Time-limited period to submit application. The Department will accept applications for certification for the Primary Care Tax Credit Program until the application acceptance period is closed by the Department, unless the application acceptance period is extended pursuant to Subsection 3(F). Upon receipt, the Department stamps the date and time (hour, minute, second) of receipt on application. To be considered timely, applications must be postmarked no earlier than January 15 and not later than February 15 or the first business day thereafter following the tax year for which the application pertains. Only applications postmarked during the time-limited submission period shall be considered by the Department during the applicable tax year.F.Extension. The Department has the discretion to extend the application submission deadline. When there is an extension, the Department shall post the notice on its publicly accessible webpage within three business days after the deadline established in this rule.G.Department verification. Information provided as part of applications is subject to Department verification, monitoring, and audit. 1. Location of practice in underserved area. The Department will verify that an applicant's practice location meets the statutory definition of underserved area.2. Background check. The applicant must have no public record of a failure to comply with service or payment obligations or professional licensure obligations and no record of an exclusion from Medicare or any state's Medicaid program. Submission of an application for tax credit certification authorizes the Department to verify, monitor and audit this information.3. False statement. A false statement submitted as part of an application is grounds for denial of the application, decertification, and sanctions, in accordance with federal and State law. An applicant found by the Department to have made a materially false statement in an application to the Primary Care Tax Credit Program may not reapply. Whether a false statement was material is within the discretion of the Department.10-144 C.M.R. ch. 298, § 3