Supplemental Needs Pooled Trust Forms

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