All Forms

This page contains all of CFMF’s forms. Please contact our Administrative Office if you need assistance.

The Huntington National Bank became Trustee of all Community Fund Trusts effective October 1, 2019. We are unable to accept any Joinder Applications identifying Equity Trust Company as Trustee after September 30, 2019. Please contact our Trust Development Coordinators at (216) 736-4540 if you have any questions regarding forms to establish a new Trust.

Pooled Medicaid Payback Trust (Starting 10/01/19) – NEW

• The Pooled Medicaid Payback Trust Starter Kit contains all of the forms and instructions necessary to establish a new Pooled Medicaid Payback Trust. It includes:
  • Attorney Instructions
  • Pooled Medicaid Payback Trust Joinder Application
  • Attorney Acknowledgment
  • W-9
  • Notice to Beneficiaries Age 65 or Older and Their Legal Counsel
  • Opt-Out of Paper Statements for PMPTs (to be signed by Designated Advocate)
  • Deposit Instructions
  • Trust Comparison Fee Schedule
  • About Trusts
  • Tax Notice
  • 12th Restatement of The Community Fund Management Foundation Pooled Medicaid Payback Trust Agreement
• CFMF has partnerships with four Ohio nonprofits: Jewish Federation of Cleveland, Hattie Larlham, ADD, and The Arc of Ohio. One of the following Joinder Agreements should be used if the person establishing the Pooled Medicaid Payback Trust wishes for the named organization to receive trust funds at the death of the beneficiary:
  • Jewish Federation of Cleveland Pooled Medicaid Payback Trust Joinder Application
  • Hattie Larlham Pooled Medicaid Payback Trust Joinder Application
  • ADD Pooled Medicaid Payback Trust Joinder Application
  • The ARC of Ohio Pooled Medicaid Payback Trust Joinder Application

Master Trust (Starting 10/01/19) – NEW

• The Master Trust Starter Kit contains all of the forms and instructions necessary to establish a new third-party discretionary Master Trust. It includes:
  • Attorney Instructions
  • Master Trust Joinder Application
  • Attorney Acknowledgment
  • W-9
  • Opt-Out of Paper Statements for Revocable Master Trusts (to be signed by Grantor(s))
  • Opt-Out of Paper Statements for Irrevocable Master Trusts (to be signed by Designated Advocate)
  • Deposit Instructions
  • Trust Comparison Fee Schedule
  • About Trusts
  • Tax Notice
  • 4th Restatement of The Community Fund Management Foundation Master Trust Agreement
• CFMF has partnerships with four Ohio nonprofits: Jewish Federation of Cleveland, Hattie Larlham, ADD, and The Arc of Ohio. One of the following Joinder Agreements should be used if the person establishing the Master Trust wishes for the named organization to receive trust funds at the death of the beneficiary:
  • Jewish Federation of Cleveland Master Trust Joinder Application
  • Hattie Larlham Master Trust Joinder Application
  • ADD Master Trust Joinder Application
  • The Arc of Ohio Master Trust Joinder Application

Notices Regarding the Change in Trustee (Starting 10/01/19)

• Notice to Grantors of Revocable Master Trusts
• Notice to Designated Advocates of Irrevocable Master Trusts
• Notice to Designated Advocates of Pooled Medicaid Payback Trusts
• Notice to Designated Advocates of Roll-In Pooled Medicaid Payback Trusts
• Notice to Attorneys

About CFMF

• Notice of Change of Address (Starting 10/15/2018)
• Contact List
• 2019 Holiday Schedule

Trust Distributions

• Common Distribution Requests
• Distribution Request Form
• Beneficiary Resource Record
• Instructions for Designated Advocates
• Receipt Log for Advances
• Distribution Packet for New Designated Advocates of Funded Trusts (Starting 10/01/2019) – NEW

Trust Distributions – Policy

• Common Distribution Requests
• Food (November 2017)

Trust Administration

• About our Trust
• Authorization to Release Information
• Change of Address
• Deposit Instructions
• Deposit Slip
• Trust Comparison Fee Schedule (Starting 10/01/19)
• Opt-Out of Paper Statements For Irrevocable PMPTs and Master Trusts (Starting 10/01/2019)
• Opt-Out of Paper Statements for Revocable Master Trusts (Starting 10/01/2019)
• Tax Notice

Reference

• Special Needs Alliance’s Special Needs Trust Handbook
• 2018 Annual Report
• 2017 Annual Report
• 2016 Annual Report
• Chart Comparing ABLE Accounts and Trusts

Grants

We are pleased to announce that all 2019 grant funds have been designated or awarded. No further 2019 applications will be accepted. Our grant program will re-open in January 2020. Please visit our website in January 2020 for more information and our updated application forms.

• Grant Application Instructions
• Grant Application for Individuals
• Grant Application for Nonprofits