Special Needs Trust

1. Answer as complete as possible as data provided are relevant for the documents we are preparing for you.

2. If the situation does not apply to you, write “Not Applicable”. If a specific blank is provided, put an “X” for your choice.

3. Do not hesitate to fill out the table even if the format will be affected, as long as the data provided is complete. If there is a need to add more rows and columns, please do so.

4. In case you have old documents related to the documents we are drafting and preparing for you (like a current Durable Power of Attorney, Health Care Directive, etc.) please email them to us. This is to ensure a complete understanding of your current situation and accuracy of data in your documents.