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Self Funded Trust

New Forms (for submissions beginning Jan. 1, 2023)

Wispact Trust I Self-Funded

  • Master Trust I – Restatement (Fully Executed 12-08-2022)

Beneficiary-Funded Trust I Creation Documents

  • Attorney Checklist (2023)
  • Contribution Agreement to Establish Sub-Account – Trust I (2023)
  • Wispact Retained Fund Grant Policy Acknowledgement (2023)
  • Individual Spending Plan (2023)
  • IRS Form W9 for Beneficiary (link to external irs.gov)
  • SSA Release of Information BPQY (2018)
  • Medicaid/DHS Release of Information
  • Contact and Planning Information (2021)
  • Heirs at Law (2023)
  • Loan Agreement (2020)
  • Creation Grant Application (2023)

Retained Fund Sub-Account Creation Documents

  • Attorney Checklist (2023)
  • Contribution Agreement to Establish Retained Fund Sub-Account-Trust I (2023)
  • Wispact Retained Fund Grant Policy Acknowledgement (2023)
  • Contact and Planning Information (2021)
  • Loan Agreement (2020)

 

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Madison, WI 53714

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Wispact Inc. is a private nonprofit organization that administers pooled and community Special Needs Trusts for people with disabilities. Based in Madison, Wispact manages the Special Needs Trusts for more than 3,000 people throughout the state of Wisconsin.

© 2020 Wispact, Inc | Disclaimer | Accessability Statement | Board of Directors Login

Documents required to establish a Wispact Trust are provided as a service to the Wisconsin legal community. Wispact Trust I and II Contribution Agreements have been approved by the State of Wisconsin, copyrighted and may not be altered. Establishing a Special Needs Trust is a complex and exacting process, and if executed improperly may carry penalties. Therefore, Wispact Trust documents must be completed and submitted only by a licensed Wisconsin attorney.

ATTORNEYS: You must read and agree to the Attorney Disclaimer before continuing to the next page.