Self Funded Trust

Wispact Trust I Self-Funded

• Wispact-Master-Trust-I-November-2016   (11-2016)
• Attorney Instructions for Trust I (2018)
• Attorney Checklist (2017)
• Trust I Contribution Agreement – Application (2016)
• Fee-Disclosure (effective October 1, 2015)
• Asset Transfer (Funding) Record (2016)
• IRS Form W9 
• Contact and Planning (2017)
• Social Security Release of Information for IRS
• Wispact SSA Release 
• Medicaid Release of Information
• Heirs-At-Law Trust
• Customer Identification Program Form
• Court File Release Form

If you are also establishing a Medicare Set-Aside Sub-trust, please contact Kristi Papez at kpapez@wispact.org, to request those creation forms.

Looking for information regarding placing unique assets into a Wispact Trust? Download the form below.

Do you require creation forms for self-funded 1396(p)(d)(4)(A) trusts? View the documents here.