Secondary Advocate 2. Mr. Mrs. Ms. Last 4 Digits of SSN: Address: City: State: Zip: Cell Phone: Home Phone: Email Address: Work Phone: *Relationship to Beneficiary: Permission to receive financial account information? a) Immediately upon funding? ☐ YES ☐ NO b) If requested in the future? ☐ YES ☐ NO If YES to a) or b), indicate financial account access preference: ☐Online ☐Mail
Appears in 8 contracts
Samples: Third Party Pooled Special Needs Trust Joinder Agreement, Third Party Pooled Special Needs Trust Joinder Agreement, Third Party Pooled Special Needs Trust Joinder Agreement
