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Supplemental Needs Forms

Supplemental Needs Pooled Trust Forms

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To open a Supplemental Needs Pooled Trust, complete and sign the following forms for the individual’s state of residence:

Minnesota

LSS Supplemental Needs Pooled Trust Master Trust Agreement  PDF

LSS Supplemental Needs Pooled Trust Joinder Agreement  DOC

Grantor Wishes Document for Use of Funds  DOC

IRS W9 Form  PDF

 

North Dakota

LSS Third-Party (Supplemental Needs) Pooled Trust Master Trust Agreement – PDF

LSS Third-Party (Supplemental Needs) Pooled Trust Joinder Agreement – DOC

Grantor Wishes Document for Use of Funds – PDF

IRS W9 Form – PDF

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Pooled Trust Services