Forms + Docs
Trust Agreements
The Full Life Center Pooled Special Needs Trust Agreement Establishes a legal agreement between the Trust Advisor, FLC, and the Trustee, Huntington National Bank to create a first party pooled trust.
Joinder Agreement Joins the Beneficiary’s trust sub-account to The Full Life Center Pooled Special Needs Trust. Please note the original document must be signed by the Grantor in front of a notary.
Enrollment Checklist Outlines all steps required for joining the trust.
Attorney Acknowledgment Requires representative attorney review and signature.
Fee Schedule Indicates the trust fees and requires Beneficiary or his/her legal representative signature.
Beneficiary Information Form Provides pertinent Beneficiary information necessary to properly administer the trust.
Grantor Objectives and Beneficiary Profile Details the Grantor’s vision for the trust and helps us get to know the Beneficiary.
W-9 Provides the Beneficiary’s correct Tax Identification Number (TIN) for IRS reporting purposes.
Duties & Responsibilities of Beneficiary Advocate Requires the Beneficiary Advocate to review his/her responsibilities and sign form to accept responsibilities.
Supplementary Documents
Consent for Release of Information Authorizes the release of confidential information regarding the Beneficiary’s trust sub-account.
Change Form Notifies FLC of any changes that impact the Beneficiary’s trust sub-account.
The Full Life Center Discretionary Trust Agreement
Establishes a legal agreement between the Trust Advisor, FLC, and the Trustee, Huntington National Bank to create a third party pooled trust.
Joinder Agreement Joins the Beneficiary’s trust sub-account to The Full Life Center Discretionary Trust. Please note the original document must be signed by the Grantor in front of a notary.
Enrollment Checklist Outlines all steps required for joining the trust.
Attorney Acknowledgment Requires representative attorney review and signature.
Fee Schedule Indicates the trust fees and requires Beneficiary or his/her legal representative signature.
Beneficiary Information Form Provides pertinent Beneficiary information necessary to properly administer the trust.
Grantor Objectives and Beneficiary Profile Details the Grantor’s vision for the trust and helps us get to know the Beneficiary.
W-9 Provides the Beneficiary’s correct Tax Identification Number (TIN) for IRS reporting purposes.
Duties & Responsibilities of Beneficiary Advocate Requires the Beneficiary Advocate to review his/her responsibilities and sign form to accept responsibilities.
Supplementary Documents
Consent for Release of Information Authorizes the release of confidential information regarding the Beneficiary’s trust sub-account.
Change Form Notifies FLC of any changes that impact the Beneficiary’s trust sub-account.
Budgeting and Contributions
Budget & Spending Plan Establishes financial goals to ensure maximum benefits for the Beneficiary and longevity of the trust.
Notification Letter Notifies family members and future donors of Beneficiary’s trust.
Contribution Form Ensures the contribution is properly deposited to the Beneficiary’s trust sub-account and accompanies contribution check.
Disbursements and Appeals
Guideline for Disbursements Provides guidance for Beneficiaries requesting expenditures.
Disbursement Request Form Requests for expenditures are made using this form and must be submitted to FLC using form, along with supporting documentation.
Denied Disbursement Request Form Provides notification to the Beneficiary’s Advocate that a disbursement request has been denied and the reason for the denial.
Appeal For Denied Disbursement Request Form Allows the Beneficiary Advocate to appeal denied disbursement requests.
Beneficiary Advocate
Beneficiary Information Form Provides pertinent Beneficiary information necessary to properly administer the trust.
Change Form Notifies FLC of any changes that impact the Beneficiary’s trust sub-account.
Consent for Release of Information Authorizes the release of confidential information regarding the Beneficiary’s trust sub-account.
Policies and Handbook (coming soon)
Guardianships
Serving Tuscarawas County Residents
Request for Guardian Services Requests FLC to initiate guardianship services.
Expert Evaluation Documents a licensed physician or clinical psychologist’s recommendation for guardianship services.
Volunteers
Serving Tuscarawas County Residents
Guardian Program Qualifications Outlines requirements perspective volunteers must meet in order to volunteer for the Guardianship Program.
Guardian Program Application Provides application to submit to apply for a volunteer position with FLC.
Guardian’s Annual Report Updates the Court annually on the ward’s health condition.
Guardianship Change Form Updates new contact information for the ward and/or guardian.
Guardian Confidentiality Agreement Ensures FLC client information is kept confidential.
Guardianship Online Training Provides online training for volunteers. To access the training, go to the website, scroll down to Education and select Guardians of Adults. Follow instructions to register and create account.
