Payment Request Form To be submitted with supporting documentation for each disbursement request. You will need to fill out the form online and attach an electronic file to support your request (ex. scanned receipts, photos of receipts, etc.). Keep confidential as the trust account number is to be included on this form.
Complete this form to submit with copies of receipts. Please send only copies of receipts; originals of receipts are not accepted. Be sure that copies of receipts can be clearly read.
This should be submitted along with a Payment Request Form to request mileage reimbursement for driving the Beneficiary to medical appointments and other destinations to which transportation is necessary.
Change of Contact Information
To change the contact information for the Beneficiary and/or Advocate (Mailing Address, Home Phone Number, Business Phone Number, Cell Phone Number, Email Address or Other Changes).
Consent for Release of Information Form
Submission of this form gives CCT staff permission to speak with a named individual(s) regarding the Special Needs Trust for the benefit of the named Beneficiary. This form must be completed and signed by an Advocate for the trust. Confidential financial information, including the balance of the trust account, will not be disclosed. Completion of this form does not give the individual authorization to submit Payment Request Forms for disbursements from the trust.
Needs vs. Wants This form gives the Beneficiary a better idea of how the money in his or her trust can be best spent. A table is also provided in the form which the Beneficiary can utilize for distinguishing between needs and wants.