Payment Request Form

The Payment Request Form is required when requesting a disbursement from a trust. Please follow these guidelines when submitting a disbursement request to CCT:

  • Must be completed entirely and signed by the Advocate on behalf of the Beneficiary
  • Requests must include an invoice, copy of receipt, or price quote.
  • Incomplete requests will result in delayed processing time.
  • Original receipts are NOT accepted — copies of receipts only.
  • Requests require up to 14 days for processing. Please plan accordingly.

Click here to download the Payment Request Form.

Click here to submit a Payment Request online.

 


Note:  Requires Adobe Reader
Download Adobe Reader

If you wish to fill out the form using a computer, you must first save the form to your computer (e.g. Desktop) and then open in Adobe Reader.  See How to fill out forms using Adobe Reader for more information.

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