Personal Representative. The Personal Representative is responsible for providing information and updates about the Individual with Disabilities. The Personal Representative is also responsible for asking the Trust to expend funds for the Individual with Disabilities, and providing supporting information. Name: Address: City, State, Zip: Telephone(s): Email: Relationship to Individual with Disabilities: In case the Personal Representative named above is unable or unwilling to serve or to continue to serve in that capacity, the Grantor(s) names the following Successor Personal Representatives to serve (in the order listed): Name: Address: City, State, Zip: Telephone(s): Email: Relationship to Individual with Disabilities: Address: City, State, Zip: Telephone: Cell/Mobile: Email: Relationship to Individual with Disabilities:
Appears in 2 contracts
Samples: Third Party Pooled Flexible Spending Trust Account Agreement, Third Party Pooled Flexible Spending Trust Account Agreement
Personal Representative. The Personal Representative is responsible for providing information and updates about the Individual with Disabilities. The Personal Representative is also responsible for asking the Trust to expend funds for the Individual with Disabilities, and providing supporting information. Name: Address: City, State, Zip: Telephone(s): Email: Relationship to Individual with Disabilities: In case the Personal Representative named above is unable or unwilling to serve or to continue to serve in that capacity, the Grantor(s) Qualified Donor names the following Successor Personal Representatives to serve (in the order listed): Name: Address: City, State, Zip: Telephone(s): Email: Relationship to Individual with Disabilities: Name: Address: City, State, Zip: Telephone: Cell/Mobile: Telephone(s): Email: Relationship to Individual with Disabilities:
Appears in 2 contracts