ÿWPCî çpK!fU‘pT¡ª2r6-¡tŸ/¸®¦«wgb2Ïp¸Vµ%QÿÅW¹Ø|Ⱥç£BaÃ](ðšùXˆÕ—Æ¥pÕ Gü,<'ÒïNÃÞÍpͼР5^ô–OÞ¡½dßËK[ö}1^%Ÿ•SíxZûcdGåH”TǬ,yœäêgKIñ/¦ZT‡(h1!®0ã¸ê…¹v©]ðbè¸ú~´äË›±ÃO#w|ïÖ'02¶*‰‡€F}У¢Iµl¯€·gš\å dÔaíŸèÑg2ó˜…ËýÖHŒ8R-IªIQ­|…MÑ"VÁpÌ-#\Ör—v«).ýmªOÔÏÉ3Ÿ7h4ñš¯K͆%.jÁ—=¤Ì¥É$\Á…cÎ>¦Å[ø•-¡]÷ÕEX°«»ªJ©F4ü…§i«É0'@ M…¬€GEv´œ-òÛ¦œ«Ÿ!¨`íMµóÆÙeÒnU«ÂÓùóPð(`§ôMaÍcx·ÇüA¢Ò iš€äs1Ù"’æwˆT —ó®ò±ìËg¢ó`ÍÂEã®K1 ŸZÖkï¯|<“6áÑ2²¦Ù Ú$Ší¾¿¶âOköXÏÎíåK¶K¥ìTáùžGe™TƒŸRöå#!†UN§ %õ 0kûU>fUN¤ 1uò 0wg^ Þwê4# m%%%%%%%%%%%%%%%%%%%%%%%%%%%f<< 1i>>>>>>>>> B§§§§fÄÄÄfÆÆÆÆÆÆaÈÈÈÈÈÈÈÈÈÆÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜÜa¢ ¶¶¶f¼a¾¾¾fÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒÒaÔÔÔÔÔÔÔÔaèfüaþfaf(a*f>a@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@Tj€–¬ÂؘHP LaserJet 4M Plus,ð,,,,,ð0(ÈhH  Z6Times New Roman RegularX(Ch$¡¡Ô€XbKXXXÔÔ  ÔÔ  ÔÓ  Ó/LÀÄ AZ&Univers Regular(ÖÃ9 Z ‹6Times New Roman Regular3#37=CIQYag­­1.a.i.(1)(a)(i)1)a)(Oé;$µµà0  àÔ2#ÔÚ  ÚaÚ  Ú.Ô3  Ôà0` (#(#à˜†¹$¬ DýŒµ$ê:i¢Ø+003|xÿU‹ÿÀÀÀL$ÿÿ35;AGMU]c1A.1.A.1.(1)(a)i)a) d‰‰TABLE B1, 2, 3,Level 1Level 2Level 3Level 4Level 5TABLE BÈ ®TABLE J‰TABLE BTABLE F¬TABLE EJTABLE Gð»TABLE HD†TABLE IAppendix KAppendix LAppendix MAppendix NAppendix OAppendix PAppendix QÝ ƒh!ÝÔ€XbXXXÔÔ  ÔÔ  ÔÓ  ÓÝ  ÝÔ_ÔÔ_ÔññññÔ‡XÒlXXXbÔÔ‡Ô£XXbÔññññññññà@xxìàò òÔ  ÔAPPENDIX€K€ð"ð€Combined€Application€For€Guardianship€And€Creation€of€867€Trust€Where€NoˆÐ ° ÐGuardianship€ExistsÔ ÆÔó óÔ €Þ ÔÐ €Ð ÐÌÔ*‹ƒ)4©ddd Xdd Xdd X°(#°(#‹ÔÔ,¤dd ÔÔ+  ÔÐ  "r ÐOften€the€need€for€an€867€Trust€is€apparent€before€a€guardianship€is€in€place.€€In€these€cases,€it€makes€moreÏsense€to€proceed€directly€with€creation€of€an€867€Trust€without€the€appointment€and€qualification€of€aÏguardian.€€However,€prior€to€1997€only€a€guardian€could€apply€for€creation€of€an€867€Trust.€€Since€one€doesÏnot€become€a€guardian€until€one€is€appointed€and€qualifies,€appointment€of€a€guardian€was€a€prerequisite€toÏcreation€of€an€867€Trust.€€In€1997€Section€867€was€amended€to€permit€a€wardððs€attorney€ad€litem€ð ðòòat€any€timeÐ Î  Ðafter€the€date€of€the€attorneyððs€appointmentððóó€to€apply€for€creation€of€an€867€Trust€and€to€permit€the€court€toÐ   ð  Ðorder€third€parties€to€transfer€funds€directly€to€the€trustee€of€an€867€Trust€without€the€need€for€the€property€toÏpass€through€the€hands€of€a€guardian€of€the€estate.€€Thus,€now€an€applicant€can€try€to€convince€an€attorney€adÏlitem€to€apply€for€creation€of€an€867€Trust€before€a€guardian€is€appointed,€obviating€the€need€for€aÏguardianship.€€This€application€anticipates€that€an€attorney€ad€litem€will€be€appointed€who€can€be€convincedÏto€file€a€related€application€(see€Appendix€L)€for€creation€of€an€867€Trust.Ð º  ÐÌà@%ìàò òNO.€_______ˆÐ ŽÞ  ÐÌGUARDIANSHIP€OFà@¿¿*ìàððˆà0  àà0p(#(#àIN€THE€PROBATE€COURTÐ.~p(#p(# Ðà@¿¿*ìàððˆÌ_________________________,à@¿¿*ìàððˆà0  àà0p(#(#àà0Èp(#p(#àà0 È(#È(#àà0x (# (#àOFÐÎx(#x(# Ðà@¿¿*ìàððˆÌòò[A€MINOR][AN€INCAPACITATED€PERSON]óóà@¿¿*ìàððˆà0  àà0p(#(#à______________€COUNTY,€TEXASÐn¾p(#p(# ÐÌà@ ìàòòAPPLICATION€FOR€GUARDIANSHIP€AND/OR€CREATION€OF€GUARDIANSHIPˆÐ ` ÐMANAGEMENT€TRUSTóóó óÐ à0 ÐÌà  à______________€(ð ðApplicantðð)€files€this€application€for€the€appointment€of€a€guardian€and/or€forÏcreation€of€a€guardianship€management€trust€for€the€benefit€of€____________€(the€ð ðProposed€Wardðð),€òò[aÐ T¤ Ðminor][an€incapacitated€person],óó€pursuant€to€Tex.€Prob.€Code€Ann.€ðð867.€€In€support€of€this€application,Ð &v ÐApplicant€would€show€the€Court€as€follows:ÌÌà  à1.à ` àThe€Proposed€Ward€is€òò[a€minor][an€incapacitated€person].óó€€The€Proposed€Wardððs€name,€sex,Ð œì Ðdate€of€birth€and€address€are€as€follows:_______________.ÌÌà  à2.à ` àApplicantððs€name,€address€and€relationship€to€the€Proposed€Ward€are€as€follows:€__________.Ð !b" ÐÌà  à3.à ` àApplicant€is€seeking€the€creation€of€a€guardianship€management€trust€pursuant€to€Tex.€Prob.Ð ¶"$ ÐCode€Ann.€ðð867.€€Only€if€required€by€the€Court€for€creation€of€a€guardianship€management€trust,€or,Ïalternatively,€only€if€the€Court€refuses€to€create€a€guardianship€management€trust,€Applicant€seeks€theÏappointment€of€a€guardian€of€the€estate€and€person€of€the€Proposed€Ward.ÌÌà  à4.à ` àThe€nature€and€degree€of€the€Proposed€Wardððs€incapacity,€the€specific€areas€of€protection€andÐ Ð& ") Ðassistance€requested,€and€the€limitation€of€rights€requested€to€be€included€in€the€Courtððs€order€are€asÏfollows:___________________.ÌÌà  à5.à ` àThe€facts€requiring€the€guardianship€management€trust€to€be€created€and€the€interest€ofÐ *h%- ÐApplicant€in€such€creation€are€as€follows:€The€Proposed€Ward€needs€the€assistance€of€a€trustee€in€managing€theÏProposed€Wardððs€estate.€€Creation€of€a€guardianship€management€trust,€rather€than€a€guardianship€of€the€estate,Ïis€in€the€best€interests€of€the€Proposed€Ward.€€Applicant€believes€that€creation€of€a€guardianship€managementÏtrust€is€in€the€Proposed€Wardððs€best€interests.€òò[Add€more€facts€as€desired€or€appropriate.]óóÐ `-°(1 ÐÔ_Ô‡à  à6.à ` àNo€guardianship€exists€for€the€Proposed€Ward,€to€the€knowledge€of€Applicant.Ð ° ÐÌà  à7.€€The€name€and€address€of€any€person€or€institution€having€the€care€and€custody€of€the€Proposed€WardÏis€as€follows:_______________.ÌÌà  à8.à ` àThe€approximate€value€and€description€of€the€Proposed€Wardððs€property,€including€anyÐ Ê Ðcompensation,€pension,€insurance,€or€allowance€to€which€the€Proposed€Ward€may€be€entitled,€to€the€knowledgeÏof€Applicant,€is€as€follows:_______________.ÌÌà  à9.à ` àThe€requested€term€of€the€guardianship€management€trust€is€as€stated€in€the€proposed€form€ofÐ  b  Ðthe€trust€attached€hereto€as€Exhibit€ð ðAðð€and€incorporated€herein.ÌÌà  à10.à ` àThe€name€and€address€of€any€person€whom€the€applicant€knows€to€hold€a€power€of€attorneyÐ ˆØ  Ðsigned€by€the€Proposed€Ward€and€a€description€of€the€type€of€power€of€attorney€is€as€follows:___________.ÌÌà  à11.à ` àòò[If€the€Proposed€Ward€is€a€minor,€include€the€names€of€the€parents€and€next€of€kin€of€theÐ þN  ÐProposed€Ward€and€a€statement€as€to€whether€either€or€both€of€the€parents€are€deceased.]óóÐ Ð  ÐÌà  à12.à ` àòò[If€the€Proposed€Ward€is€a€minor,€include€a€statement€as€to€whether€the€minor€was€the€subjectÐ tÄ Ðof€a€legal€or€conservatorship€proceeding€within€the€preceding€two„year€period€and,€if€so,€the€court€involved,Ïthe€nature€of€the€proceeding,€and€the€final€disposition,€if€any,€of€the€proceeding.]óóÐ h ÐÌà  à13.à ` àòò[If€the€Proposed€Ward€is€60€years€of€age€or€older,€include€the€names€and€addresses,€to€the€bestÐ ¼  Ðof€Applicantððs€knowledge,€of€the€Proposed€Wardððs€spouse,€siblings,€and€children,€or,€if€there€is€no€spouse,Ïsibling,€or€child,€the€names€and€addresses€of€the€Proposed€Wardððs€next€of€kin.]óóÐ `° ÐÌà  à14.à ` àThis€Court€has€venue€over€this€proceeding€because€the€Proposed€Ward€is€a€resident€of€and€isÐ T Ðdomiciled€in€______________€County,€Texas.ÌÌà  à15.à ` àCreation€of€a€guardianship€management€trust€pursuant€to€Tex.€Prob.€Code€Ann.€ðð867€containingÐ zÊ Ðthe€terms€and€provisions€of€the€trust€instrument€attached€hereto€as€Exhibit€"A"€and€incorporated€herein€wouldÏbe€in€the€best€interests€of€the€Proposed€Ward.€€òò[If€desired,€state€the€reasons€for€creation€of€the€867€Trust.]óóÐ n ÐÌÔ*eƒ84}dd¤dd ¤)4©°(#°(#eÔÔ,¤dd ÔÔ+  ÔÐ  Â! Ðà@ä ä ‚àò òOPTIONAL€SUPPLEMENTAL€NEEDS€TRUST€PROVISIONS:ó óˆÐ & v" ÐÌØ€JØà l à16.à Ä àIt€would€be€in€the€best€interests€of€the€Proposed€Ward€for€the€trust€to€be€a€supplemental€needsÐ È!$ Ðtrust€as€specified€under€42€U.S.C.€Section€1396p(d)(4)(A).ÌÌØ€JØà l à17.à Ä àThe€terms€of€the€trust€instrument€attached€hereto€as€Exhibit€"A"€and€incorporated€herein€areÐ >$Ž' Ðnecessary€and€appropriate€for€the€Proposed€Ward€to€be€eligible€to€receive€public€benefits€or€assistance€under€aÏstate€or€federal€program€that€is€not€otherwise€available€to€the€Proposed€Ward.Ð â%2!) ÐÌà  à18.à ` à_________________€("Trustee")€is€a€trust€company€or€a€state€or€national€bank€having€trustÐ ¶'#* Ðpowers€in€Texas€and€is€willing€to€serve€as€trustee€of€the€guardianship€management€trust€for€the€Proposed€WardððsÏbenefit.ÌÌà  à19.à ` àThe€Court€should€direct€that,€upon€creation€of€the€guardianship€management€trust,€each€personÐ þ*N&. Ðholding€property€of€the€Proposed€Ward€òò[including,€but€not€limited€to,€____________________€(specificallyÐ Ð+ '/ Ðidentify€third€parties€holding€the€Proposed€Wardððs€funds)]óó€shall€deliver€all€of€such€assets€to€Trustee,€to€be€heldÐ ¢,ò'0 Ðby€Trustee€as€the€trust€estate€of€the€trust.Ð t-Ä(1 Їà  à20.à ` àNo€guardianship€of€the€Proposed€Wardððs€person€or€estate€is€necessary,€and€the€Court€shouldÐ ° Ðorder€than€none€be€created.€€However,€if€the€Court€refuses€to€create€a€guardianship€management€trust€for€theÏWard,€or,€alternatively,€if€the€Court€requires€the€appointment€of€a€guardian€of€the€estate€and/or€guardian€of€theÏperson€of€the€Proposed€Ward€as€a€condition€to€the€creation€of€the€guardianship€management€trust,€Applicant€asksÏthat€________________€(the€ð ðProposed€Guardianðð)€be€appointed€the€guardian€of€the€estate€and/or€guardian€ofÏthe€person€of€the€Proposed€Ward.€€The€Proposed€Guardian€is€qualified€and€is€not€disqualified€to€serve€asÏguardian€of€the€person€and/or€estate€of€the€Proposed€Ward.ÌÌà@ŽŽ'ìàPRAYERˆÌÌà  àApplicant€prays€that,€after€proper€notice€and€service€of€citation,€the€Court€will€appoint€an€attorney€adÏlitem€for€the€Proposed€Ward;€that€the€Court€will€make€the€findings€and€determinations€described€above€andÏnecessary€for€the€creation€of€a€guardianship€management€trust€for€the€benefit€of€the€Proposed€Ward;€that€theÏCourt€will€create€a€guardianship€management€trust€for€the€benefit€of€the€Proposed€Ward€pursuant€to€Tex.€Prob.ÏCode€Ann.€ðð867€with€those€terms€and€provisions€set€forth€in€Exhibit€"A"€attached€hereto€and€incorporatedÏherein;€that€the€Court€will€name€Trustee€as€trustee€of€such€trust;€òò[that€the€trust€shall€be€a€supplemental€needsÐ þN  Ðtrust€as€specified€under€42€U.S.C.€Section€1396p(d)(4)(A);]óó€that€the€Court€will€order€each€person€holdingÐ Ð  Ðproperty€of€the€Proposed€Ward€to€deliver€all€of€such€assets€to€Trustee,€to€be€held€by€Trustee€as€the€trust€estateÏof€the€trust;€that€the€Court€will€find€that€no€guardianship€of€the€estate€and/or€person€of€the€Proposed€Ward€isÏnecessary,€or,€alternatively,€that€the€Court€will€appoint€the€Proposed€Guardian€as€guardian€of€the€person€and/orÏestate€of€the€Proposed€Ward;€and€that€the€Court€will€grant€such€other€and€further€relief€to€which€Plaintiff€mayÏbe€entitled.ÌÌRespectfully€submitted,ÌÌATTORNEY€FOR€APPLICANTà h àÐ  2‚ Ðà@œœìàò òÔ  ÔAPPENDIX€L€ð"ð€Attorney€Ad€Litemððs€Application€to€Create€867€Trust€Where€No€GuardianshipˆÐ ° ÐExistsÔ Ä*Ôó óÔ €ß ÔÐ €Ð ÐÌÔ*eƒ¬4­dd¤dd ¤84}°(#°(#eÔÔ,¤dd ÔÔ+  ÔÐ  "r ÐThis€form€may€be€used€by€an€attorney€ad€litem€to€apply€for€creation€of€an€867€Trust€before€a€guardian€isÏappointed.€€It€may€be€used€in€conjunction€with€Appendix€K,€in€cases€where€the€applicant€for€the€guardianshipÏalso€wants€an€867€Trust€to€be€created,€or€it€may€be€used€by€itself€in€cases€where€the€applicant€did€not€seekÏcreation€of€an€867€Trust.Ð ü L ÐÌà@%ìàò òNO.€_______ˆÐ Ð  ÐÌGUARDIANSHIP€OFà@¿¿*ìàððˆà0  àà0p(#(#àIN€THE€PROBATE€COURTÐp À p(#p(# Ðà@¿¿*ìàððˆÌ_________________________,à@¿¿*ìàððˆà0  àà0p(#(#àà0Èp(#p(#àà0 È(#È(#àà0x (# (#àOFÐ` x(#x(# Ðà@¿¿*ìàððˆÌòò[A€MINOR][AN€INCAPACITATED€PERSON]óóà@¿¿*ìàððˆà0  àà0p(#(#à______________€COUNTY,€TEXASа p(#p(# ÐÌà@kkìàòòAPPLICATION€FOR€CREATION€OF€GUARDIANSHIP€MANAGEMENT€TRUSTóóó óˆÐ R¢  ÐÌà  à________________________€(ð ðApplicantðð),€attorney€ad€litem€for€_____________________€(theÏð ðProposed€Wardðð),€òò[a€minor][an€incapacitated€person],óó€files€this€application€for€the€creation€of€a€guardianshipÐ Æ Ðmanagement€trust€for€the€benefit€of€the€Proposed€Ward€pursuant€to€Tex.€Prob.€Code€Ann.€ðð867.€€In€support€ofÏthis€application,€Applicant€would€show€the€Court€as€follows:ÌÌà  à1.à ` àThe€Proposed€Ward€is€òò[a€minor][an€incapacitated€person].óó€€The€Proposed€Wardððs€name,€sex,Ð ^ Ðdate€of€birth€and€address€are€as€follows:_________________.ÌÌà  à2.à ` àApplicant€is€the€court„appointed€attorney€ad€litem€for€the€Proposed€Ward.€€Applicantððs€nameÐ „Ô Ðand€address€are€as€follows:_________________.ÌÌà  à3.à ` àApplicant€seeks€neither€a€guardianship€of€the€person€or€estate€of€the€Proposed€Ward;€rather,Ð úJ ÐApplicant€seeks€the€creation€of€a€guardianship€management€trust€pursuant€to€Tex.€Prob.€Code€Ann.€ðð867.ÌÌà  à4.à ` àThe€nature€and€degree€of€the€Proposed€Wardððs€incapacity,€the€specific€areas€of€protection€andÐ pÀ  Ðassistance€requested,€and€the€limitation€of€rights€requested€to€be€included€in€the€Courtððs€order€are€asÏfollows:_____________.ÌÌà  à5.à ` àThe€facts€requiring€the€guardianship€management€trust€to€be€created€and€the€interest€ofÐ ¸"$ ÐApplicant€in€such€creation€are€as€follows:€The€Proposed€Ward€needs€the€assistance€of€a€trustee€in€managing€theÏProposed€Wardððs€estate.€€Creation€of€a€guardianship€management€trust,€rather€than€a€guardianship€of€the€estate,Ïis€in€the€best€interests€of€the€Proposed€Ward.€€Applicant€is€the€court„appointed€attorney€ad€litem€for€the€ProposedÏWard€and€believes€that€creation€of€a€guardianship€management€trust€is€in€the€Proposed€Wardððs€best€interests.Ð &P!( Ðòò[Add€more€facts€as€desired€or€appropriate.]óóÐ Ò&"") ÐÌà  à6.à ` àNo€guardianship€exists€for€the€Proposed€Ward,€to€the€knowledge€of€Applicant.€_____________Ð v(Æ#+ Ðhas€filed€an€application€for€appointment€of€a€guardian,€and€that€application€is€pending€in€this€Court€under€thisÏcause€number.€òò[If€accurate:€_________________€consents€to€the€creation€of€a€guardianship€management€trustÐ *j%- Ðin€lieu€of€a€guardianship€of€the€estate€pursuant€to€Tex.€Prob.€Code€Ann.€ðð867.]óóÐ ì*<&. ÐÌà  à7.€€The€name€and€address€of€any€person€or€institution€having€the€care€and€custody€of€the€Proposed€WardÏis€as€follows:________________.Ð b-²(1 Їà  à8.à ` àThe€approximate€value€and€description€of€the€Proposed€Wardððs€property,€including€anyÐ ° Ðcompensation,€pension,€insurance,€or€allowance€to€which€the€Proposed€Ward€may€be€entitled,€to€the€knowledgeÏof€Applicant,€is€as€follows:_____________.ÌÌà  à9.à ` àThe€requested€term€of€the€guardianship€management€trust€is€as€stated€in€the€proposed€form€ofÐ øH Ðthe€trust€attached€hereto€as€Exhibit€ð ðAðð€and€incorporated€herein.ÌÌà  à10.à ` àThe€name€and€address€of€any€person€whom€the€applicant€knows€to€hold€a€power€of€attorneyÐ n ¾ Ðsigned€by€the€Proposed€Ward€and€a€description€of€the€type€of€power€of€attorney€is€as€follows:___________.ÌÌà  à11.à ` àòò[If€the€Proposed€Ward€is€a€minor,€include€the€names€of€the€parents€and€next€of€kin€of€theÐ ä 4  ÐProposed€Ward€and€a€statement€as€to€whether€either€or€both€of€the€parents€are€deceased.]óóÐ ¶   ÐÌà  à12.à ` àòò[If€the€Proposed€Ward€is€a€minor,€include€a€statement€as€to€whether€the€minor€was€the€subjectÐ Zª  Ðof€a€legal€or€conservatorship€proceeding€within€the€preceding€two„year€period€and,€if€so,€the€court€involved,Ïthe€nature€of€the€proceeding,€and€the€final€disposition,€if€any,€of€the€proceeding.]óóÐ þN  ÐÌà  à13.à ` àòò[If€the€Proposed€Ward€is€60€years€of€age€or€older,€include€the€names€and€addresses,€to€the€bestÐ ¢ò  Ðof€Applicantððs€knowledge,€of€the€Proposed€Wardððs€spouse,€siblings,€and€children,€or,€if€there€is€no€spouse,Ïsibling,€or€child,€the€names€and€addresses€of€the€Proposed€Wardððs€next€of€kin.]óóÐ F– ÐÌà  à14.à ` àThis€Court€has€venue€over€this€proceeding€because€the€Proposed€Ward€is€a€resident€of€and€isÐ ê: Ðdomiciled€in€______________€County,€Texas.ÌÌà  à15.à ` àCreation€of€a€guardianship€management€trust€pursuant€to€Tex.€Prob.€Code€Ann.€ðð867€containingÐ `° Ðthe€terms€and€provisions€of€the€trust€instrument€attached€hereto€as€Exhibit€"A"€and€incorporated€herein€wouldÏbe€in€the€best€interests€of€the€Proposed€Ward.€€òò[If€desired,€state€the€reasons€for€creation€of€the€867€Trust.]óóÐ T ÐÌÔ*eƒ;4Add¤dd ¤¬4­°(#°(#eÔÔ,¤dd ÔÔ+  ÔÐ  ¨ø Ðà@ä ä ‚àò òOPTIONAL€SUPPLEMENTAL€NEEDS€TRUST€PROVISIONS:ó óˆÐ  \ ÐÌØ€JØà l à16.à Ä àIt€would€be€in€the€best€interests€of€the€Proposed€Ward€for€the€trust€to€be€a€supplemental€needsÐ ®þ Ðtrust€as€specified€under€42€U.S.C.€Section€1396p(d)(4)(A).ÌÌØ€JØà l à17.à Ä àThe€terms€of€the€trust€instrument€attached€hereto€as€Exhibit€"A"€and€incorporated€herein€areÐ $ t" Ðnecessary€and€appropriate€for€the€Proposed€Ward€to€be€eligible€to€receive€public€benefits€or€assistance€under€aÏstate€or€federal€program€that€is€not€otherwise€available€to€the€Proposed€Ward.Ð È!$ ÐÌà  à18.à ` à_______________€("Trustee")€is€a€trust€company€or€a€state€or€national€bank€having€trust€powersÐ œ#ì% Ðin€Texas€and€is€willing€to€serve€as€trustee€of€the€guardianship€management€trust€for€the€Proposed€Wardððs€benefit.ÌÌà  à19.à ` àThe€Court€should€direct€that,€upon€creation€of€the€guardianship€management€trust,€each€personÐ &b!( Ðholding€property€of€the€Proposed€Ward€òò[including,€but€not€limited€to,€_____________€(specifically€identify€thirdÐ ä&4") Ðparties€holding€the€Proposed€Wardððs€funds)]óó€shall€deliver€all€of€such€assets€to€Trustee,€to€be€held€by€TrusteeÐ ¶'#* Ðas€the€trust€estate€of€the€trust.ÌÌà  à20.à ` àNo€guardianship€of€the€Proposed€Wardððs€estate€is€necessary.Ð ,*|%- ÐÌà  à21.à ` àòò[If€desired:€No€guardianship€of€the€Proposed€Wardððs€person€is€necessary.]óóÐ Ð+ '/ ÐÌà  à22.à ` àUpon€entry€of€the€Courtððs€order€creating€the€guardianship€management€trust,€Applicant,€attorneyÐ t-Ä(1 Ðad€litem€for€the€Proposed€Ward,€should€be€paid€a€reasonable€fee€from€the€trust€and€should€be€discharged.ÌÌà@ŽŽ'ìàPRAYERˆÌÌà  àApplicant€prays€that€the€Court€will€make€the€findings€and€determinations€described€above€and€necessaryÏfor€the€creation€of€a€guardianship€management€trust€for€the€benefit€of€the€Proposed€Ward;€that€the€Court€willÏcreate€a€guardianship€management€trust€for€the€benefit€of€the€Proposed€Ward€pursuant€to€Tex.€Prob.€Code€Ann.Ïðð867€with€those€terms€and€provisions€set€forth€in€Exhibit€"A"€attached€hereto€and€incorporated€herein;€that€theÏCourt€will€name€Trustee€as€trustee€of€such€trust;€òò[that€the€trust€shall€be€a€supplemental€needs€trust€as€specifiedÐ @  Ðunder€42€U.S.C.€Section€1396p(d)(4)(A);]óó€that€the€Court€will€order€each€person€holding€property€of€the€ProposedÐ  b  ÐWard€to€deliver€all€of€such€assets€to€Trustee,€to€be€held€by€Trustee€as€the€trust€estate€of€the€trust;€that€the€CourtÏwill€award€Applicant€a€reasonable€fee€as€attorney€ad€litem,€to€be€paid€by€Trustee€upon€funding€of€the€trust€(ifÏnot€sooner€paid);€that€the€Court€will€discharge€Applicant€as€attorney€ad€litem;€and€that€the€Court€will€grant€suchÏother€and€further€relief€to€which€Plaintiff€may€be€entitled.ÌÌRespectfully€submitted,ÌÌATTORNEY€AD€LITEMÐ  ¢ò  Ðà@šš ìàò òÔ  ÔAPPENDIX€M€ð"ð€Order€Creating€867€Trust€Where€No€Guardianship€ExistsÔ PÔó óÔ €à ԈР° ÐÌÔ*eƒ®4¯dd¤dd ¤;4A°(#°(#eÔÔ,¤dd ÔÔ+  ÔÐ  R¢ ÐThis€form€may€be€used€in€cases€where€the€Court€agrees€that€an€867€Trust€should€be€created€and€where€theÏCourt€sees€no€need€for€a€guardianship€of€the€estate€(see€notes€to€Appendix€K€and€Appendix€L).Ð ˆØ ÐÌà@%ìàò òNO.€_______ˆÐ \ ¬ ÐÌGUARDIANSHIP€OFà@¿¿*ìàððˆà0  àà0p(#(#àIN€THE€PROBATE€COURTÐü Lp(#p(# Ðà@¿¿*ìàððˆÌ_________________________,à@¿¿*ìàððˆà0  àà0p(#(#àà0Èp(#p(#àà0 È(#È(#àà0x (# (#àOFÐœ ì x(#x(# Ðà@¿¿*ìàððˆÌòò[A€MINOR][AN€INCAPACITATED€PERSON]óóà@¿¿*ìàððˆà0  àà0p(#(#à______________€COUNTY,€TEXASÐ<Œ p(#p(# ÐÌà@ú ú ìàòòORDER€CREATING€GUARDIANSHIP€MANAGEMENT€TRUSTó óóóˆÐ Þ.  ÐÌà  àOn€this€day€the€Court€considered€the€Application€for€Guardianship€And/Or€Creation€of€GuardianshipÏManagement€Trust€filed€by€__________________€(ð ðApplicantðð)€and€the€Application€for€Creation€ofÏGuardianship€Management€Trust€filed€by€___________________€(ð ðAttorney€Ad€Litemðð),€attorney€ad€litem,Ïregarding€_______________________€(ð ðthe€Wardðð),€òò[a€minor][an€incapacitated€person]óó.€òò[The€Ward€attendedÐ öF Ðthe€hearing€on€the€above€applications.][The€Court€finds€that€the€Wardððs€attendance€at€the€hearing€on€the€aboveÏapplications€is€not€necessary.]óó€After€considering€the€above€applications,€the€evidence€presented,€and€theÐ šê Ðarguments€of€counsel,€the€Court€finds€by€clear€and€convincing€evidence€that€the€Ward€is€an€incapacitated€person;Ïthat€it€is€in€the€best€interest€of€the€Ward€for€the€court€to€create€a€guardianship€management€trust€for€the€WardÏpursuant€to€Tex.€Prob.€Code€Ann.€ðð867;€that€the€rights€of€the€Ward€or€the€Wardððs€property€will€be€protected€byÏthe€creation€of€a€guardianship€management€trust;€and€that,€if€a€guardianship€management€trust€is€created€for€theÏWard,€no€guardianship€of€the€estate€and/or€person€of€the€Ward€is€necessary.€€The€Court€further€finds€by€aÏpreponderance€of€the€evidence€that€the€Court€has€venue€of€this€matter€because€the€Ward€resides€in€this€county;Ð †Ö Ðòò[that€the€Ward€is€a€minor][that€the€Ward€is€totally€without€capacity€as€provided€by€the€Texas€Probate€Code€toÐ X¨ Ðcare€for€himself€or€herself€and€to€manage€the€Wardððs€property][that€the€Ward€lacks€the€capacity€to€do€some,Ïbut€not€all,€of€the€tasks€necessary€to€care€for€himself€or€herself€or€to€manage€the€Wardððs€property];óó€that€theÐ üL ÐWardððs€incapacity€is€evidenced€by€recurring€acts€or€occurrences€within€the€preceding€six„month€period€and€notÏby€isolated€instances€of€negligence€or€bad€judgment;€that€creation€of€a€guardianship€management€trust€pursuantÏto€Tex.€Prob.€Code€Ann.€ðð867€containing€the€terms€and€provisions€of€the€trust€instrument€attached€hereto€asÏExhibit€"A"€and€incorporated€herein€would€be€in€the€best€interests€of€the€Proposed€Ward;€òò[that€it€would€be€inÐ D ”! Ðthe€best€interests€of€the€Ward€for€the€trust€to€be€a€supplemental€needs€trust€as€specified€under€42€U.S.C.€SectionÏ1396p(d)(4)(A);€that€the€terms€of€the€trust€instrument€attached€hereto€as€Exhibit€"A"€and€incorporated€hereinÏare€necessary€and€appropriate€for€the€Ward€to€be€eligible€to€receive€public€benefits€or€assistance€under€a€stateÏor€federal€program€that€is€not€otherwise€available€to€the€Ward;]óó€that€____________________________Ð Œ#Ü% Ð("Trustee")€is€a€trust€company€or€a€state€or€national€bank€having€trust€powers€in€Texas€and€is€willing€to€serveÏas€trustee€of€the€guardianship€management€trust€for€the€Wardððs€benefit;€that€the€Court€should€direct€that,€uponÏcreation€of€the€guardianship€management€trust,€each€person€holding€property€of€the€Ward€òò[including,€but€notÐ &R!( Ðlimited€to,€____________________________€(specifically€identify€third€parties€holding€the€Wardððs€funds)]óóÐ Ô&$") Ðshall€deliver€all€of€such€assets€to€Trustee,€to€be€held€by€Trustee€as€the€trust€estate€of€the€trust;€and€that€upon€entryÏof€the€Courtððs€order€creating€the€guardianship€management€trust,€Attorney€Ad€Litem,€should€be€paid€the€amountÏstated€below€from€the€trust€as€a€reasonable€fee€for€serving€in€such€capacity€and€should€be€discharged.ÌÌà  àIT€IS,€THEREFORE,€ORDERED€that:ÌÌà  à1.à ` àThe€Ward€is€an€incapacitated€person;Ð ’,â'0 ÐÐ d-´(1 Ðà  à2.à ` àA€guardianship€management€trust€for€the€benefit€of€the€Ward€is€established€pursuant€to€Tex.Ð ° ÐProb.€Code€Ann.€ðð867€with€the€terms€and€provisions€set€forth€on€Exhibit€ð ðAðð€attached€hereto€and€incorporatedÏherein;ÌÌà  à3.à ` àNo€guardianship€of€the€estate€and/or€person€of€the€Ward€is€necessary;Ð øH ÐÌà  à4.à ` àòò[The€Ward€is€a€minor][The€Ward€is€totally€without€capacity€as€provided€by€the€Texas€ProbateÐ œ ì ÐCode€to€care€for€himself€or€herself€and€to€manage€the€Wardððs€property][The€Ward€lacks€the€capacity€to€do€theÏfollowing€actions:€______________________________________________];ÌÌà  à5.à ` à[It€is€in€the€best€interests€of€the€Ward€for€the€trust€to€be€a€supplemental€needs€trust€as€specifiedÐ ä 4  Ðunder€42€U.S.C.€Section€1396p(d)(4)(A),€and€the€terms€of€the€trust€instrument€attached€hereto€as€Exhibit€"A"Ïand€incorporated€herein€are€necessary€and€appropriate€for€the€Ward€to€be€eligible€to€receive€public€benefitsÏor€assistance€under€a€state€or€federal€program€that€is€not€otherwise€available€to€the€Ward;]óóÐ Zª  ÐÌà  à6.à ` à€____________________________€("Trustee"),€a€trust€company€or€a€state€or€national€bankÐ þN  Ðhaving€trust€powers€in€Texas,€is€appointed€as€trustee€of€the€guardianship€management€trust€and€is€ordered€toÏadminister€such€trust€in€accordance€with€applicable€law€and€in€accordance€with€the€terms€and€provisions€of€theÏtrust€instrument€attached€hereto€as€Exhibit€ð ðA;ððÌÌà  à7.à ` àUpon€creation€of€the€guardianship€management€trust,€each€person€holding€property€of€the€WardÐ h Ðòò[including,€but€not€limited€to,€____________________________€(specifically€identify€third€parties€holding€theÐ ê: ÐWardððs€funds)]óó€shall€deliver€all€of€such€assets€to€Trustee,€to€be€held€by€Trustee€as€the€trust€estate€of€the€trust;Ð ¼  ÐandÌÌà  à8.à ` àAttorney€Ad€Litem€is€awarded€a€fee€in€the€amount€of€$_________________€from€the€trust€asÐ 2‚ Ða€reasonable€fee€for€serving€in€such€capacity€and€is€hereby€discharged.ÌÌà  àSIGNED€this€____€day€of€______________,€_____.ÌÌÌ_________________________________________ÌJudge€PresidingÐ  ð@  Ðà@((ìàò òÔ  ÔAPPENDIX€N€ð"ð€Application€to€Create€867€Trust€From€Existing€GuardianshipÔ ºlÔó óÔ €á ԈР° ÐÌÔ*eƒ°4±dd¤dd ¤®4¯°(#°(#eÔÔ,¤dd ÔÔ+  ÔÐ  R¢ ÐThis€form€may€be€used€by€the€guardian€or€the€attorney€ad€litem€to€apply€for€creation€of€an€867€Trust€where€aÏguardianship€of€the€estate€already€exists.Ð ˆØ ÐÌà@%ìàò òNO.€_______ˆÐ \ ¬ ÐÌGUARDIANSHIP€OFà@¿¿*ìàððˆà0  àà0p(#(#àIN€THE€PROBATE€COURTÐü Lp(#p(# Ðà@¿¿*ìàððˆÌ_________________________,à@¿¿*ìàððˆà0  àà0p(#(#àà0Èp(#p(#àà0 È(#È(#àà0x (# (#àOFÐœ ì x(#x(# Ðà@¿¿*ìàððˆÌòò[A€MINOR][AN€INCAPACITATED€PERSON]óóà@¿¿*ìàððˆà0  àà0p(#(#à______________€COUNTY,€TEXASÐ<Œ p(#p(# ÐÌà@kkìàòòAPPLICATION€FOR€CREATION€OF€GUARDIANSHIP€MANAGEMENT€TRUSTóóó óˆÐ Þ.  ÐÌà  à________________________€(ð ðApplicantðð),€òò[guardian€of€the€estate€of][attorney€ad€litem€for]óóÐ €Ð  Ð_____________________€(the€ð ðWardðð),€òò[a€minor][an€incapacitated€person],óó€files€this€application€for€theÐ R¢  Ðcreation€of€a€guardianship€management€trust€for€the€benefit€of€the€Ward€pursuant€to€Tex.€Prob.€Code€Ann.€ðð867.€ÏIn€support€of€this€application,€Applicant€would€show€the€Court€as€follows:ÌÌà  à1.à ` àThe€Ward€is€òò[a€minor][an€incapacitated€person].óó€€A€guardianship€of€the€estate€of€the€WardÐ šê Ðexists€in€this€Court.ÌÌà  à2.à ` àCreation€of€a€guardianship€management€trust€pursuant€to€Tex.€Prob.€Code€Ann.€Ô% €~ Ôðð867€containingÐ ` Ðthe€terms€and€provisions€of€the€trust€instrument€attached€hereto€as€Exhibit€"A"€and€incorporated€herein€wouldÏbe€in€the€best€interests€of€Plaintiff.€€òò[If€desired,€state€the€reasons€for€creation€of€the€867€Trust.]óóÐ ´ ÐÌÔ*eƒ…4¡dd¤dd ¤°4±°(#°(#eÔÔ,¤dd ÔÔ+  ÔÐ  X¨ Ðà@ä ä ‚àò òOPTIONAL€SUPPLEMENTAL€NEEDS€TRUST€PROVISIONS:ó óˆÐ ¼  ÐÌØ€JØà l à3.à Ä àIt€would€be€in€the€best€interests€of€the€Ward€for€the€trust€to€be€a€supplemental€needs€trust€asÐ ^® Ðspecified€under€42€U.S.C.€Section€1396p(d)(4)(A).ÌÌØ€JØà l à4.à Ä àThe€terms€of€the€trust€instrument€attached€hereto€as€Exhibit€"A"€and€incorporated€herein€areÐ Ô$! Ðnecessary€and€appropriate€for€the€Ward€to€be€eligible€to€receive€public€benefits€or€assistance€under€a€state€orÏfederal€program€that€is€not€otherwise€available€to€the€Ward.Ð x!È# ÐÌà  à3.òò[5.]óóà ` à__________________€("Trustee")€is€a€trust€company€or€a€state€or€national€bank€having€trustÐ L#œ$ Ðpowers€in€Texas€and€is€willing€to€serve€as€trustee€of€the€guardianship€management€trust€for€the€Wardððs€benefit.ÌÌà  à4.òò[6.]óóà ` àThe€Court€should€direct€that,€upon€creation€of€the€guardianship€management€trust,€the€guardianÐ Â%!' Ðof€the€estate€of€the€Ward€and€any€other€person€holding€property€of€the€Ward€òò[including,€but€not€limited€to,Ð ”&ä!( Ð____________________________€(specifically€identify€third€parties€holding€the€Wardððs€funds)]óó€shall€deliverÐ f'¶") Ðall€of€such€assets€to€Trustee,€to€be€held€by€Trustee€as€the€trust€estate€of€the€trust.ÌÌà  à5.òò[7.]óóà ` àUpon€creation€of€the€guardianship€management€trust€and€upon€the€transfer€of€all€assets€in€theÐ Ü),%, Ðpossession€or€control€of€the€guardian€of€the€estate€of€the€Ward€to€Trustee,€the€Court€should€discharge€theÏguardian€of€the€wardððs€estate€pursuant€to€Tex.€Prob.€Code€Ann.€ðð868A.à È àÐ €+Ð&. ÐÌØ€JØà  à6.òò[8.]óóà ` àòò[If€desired€or€appropriate:]óóUpon€entry€of€the€Courtððs€order€creating€the€guardianshipÐ $-t(0 Ðmanagement€trust,€__________________,€attorney€ad€litem€for€the€Ward,€should€be€paid€a€reasonable€fee€fromÐ ö-F)1 Ðthe€guardianship€estate€or€the€trust€and€should€be€discharged.ÌÌà@ŽŽ'ìàPRAYERˆÌÌà  àApplicant€prays€that€the€Court€will€make€the€findings€and€determinations€described€above,€that€the€CourtÏwill€create€a€guardianship€management€trust€for€the€benefit€of€the€Ward€pursuant€to€Tex.€Prob.€Code€Ann.€ðð867Ïwith€those€terms€and€provisions€set€forth€in€Exhibit€"A"€attached€hereto€and€incorporated€herein;€that€the€CourtÏwill€name€Trustee€as€trustee€of€such€trust;€òò[that€the€trust€shall€be€a€supplemental€needs€trust€as€specified€underÐ n ¾ Ð42€U.S.C.€Section€1396p(d)(4)(A);]óó€that€the€Court€will€order€the€guardian€of€the€estate€of€the€Ward€and€any€otherÐ @  Ðperson€holding€property€of€the€Ward€to€deliver€all€of€such€assets€to€Trustee,€to€be€held€by€Trustee€as€the€trustÏestate€of€the€trust;€that€upon€creation€of€the€guardianship€management€trust€and€upon€the€transfer€of€all€assetsÏin€the€possession€or€control€of€the€guardian€of€the€estate€of€the€Ward€to€Trustee,€the€€guardian€of€the€WardððsÏestate€shall€be€discharged€pursuant€to€Tex.€Prob.€Code€Ann.€ðð868A;€òò[that€the€Court€will€awardÐ ˆØ  Ð_______________,€attorney€ad€litem,€a€reasonable€fee,€to€be€paid€by€the€guardian€of€the€estate€of€the€Ward€orÏby€Trustee€upon€funding€of€the€trust€(if€not€sooner€paid)];€that€the€Court€will€discharge€said€attorney€ad€litem;óóÐ ,|  Ðand€that€the€Court€will€grant€such€other€and€further€relief€to€which€Plaintiff€may€be€entitled.ÌÌRespectfully€submitted,ÌÌATTORNEY€FOR€APPLICANTÐ  F– Ðà@  ìàò òÔ  ÔAPPENDIX€O€ð"ð€Order€Creating€867€Trust€From€Existing€GuardianshipÔ Q„ÔÔ €â ԈР° Ðó óÌÌÌà@%ìàò òNO.€_______ˆÐ öF ÐÌGUARDIANSHIP€OFà@¿¿*ìàððˆà0  àà0p(#(#àIN€THE€PROBATE€COURTЖ æp(#p(# Ðà@¿¿*ìàððˆÌ_________________________,à@¿¿*ìàððˆà0  àà0p(#(#àà0Èp(#p(#àà0 È(#È(#àà0x (# (#àOFÐ6 †x(#x(# Ðà@¿¿*ìàððˆÌòò[A€MINOR][AN€INCAPACITATED€PERSON]óóà@¿¿*ìàððˆà0  àà0p(#(#à______________€COUNTY,€TEXASÐÖ & p(#p(# ÐÌà@ú ú ìàòòORDER€CREATING€GUARDIANSHIP€MANAGEMENT€TRUSTó óóóˆÐ xÈ  ÐÌà  àOn€this€day€the€Court€considered€the€Application€for€Creation€of€Guardianship€Management€Trust€filedÏby€___________________,€òò[attorney€ad€litem€for€___________________€(ð ðthe€Wardðð)][guardian€of€the€estateÐ ì<  Ðof€______________________€(ð ðthe€Wardðð)],óó€òò[a€minor][an€incapacitated€person]óó.€€After€considering€the€aboveÐ ¾  Ðapplications,€the€evidence€presented,€and€the€arguments€of€counsel,€the€Court€finds€that€the€Ward€is€anÏincapacitated€person;€that€it€is€in€the€best€interest€of€the€Ward€for€the€Court€to€create€a€guardianship€managementÏtrust€for€the€Ward€pursuant€to€Tex.€Prob.€Code€Ann.€ðð867€containing€the€terms€and€provisions€of€the€trustÏinstrument€attached€hereto€as€Exhibit€ð ðAðð€and€incorporated€herein;€òò[that€it€would€be€in€the€best€interests€of€theÐ V ÐWard€for€the€trust€to€be€a€supplemental€needs€trust€as€specified€under€42€U.S.C.€Section€1396p(d)(4)(A);€thatÏthe€terms€of€the€trust€instrument€attached€hereto€as€Exhibit€"A"€and€incorporated€herein€are€necessary€andÏappropriate€for€the€Ward€to€be€eligible€to€receive€public€benefits€or€assistance€under€a€state€or€federal€programÏthat€is€not€otherwise€available€to€the€Ward;]óó€that€____________________________€("Trustee")€is€a€trustÐ Nž Ðcompany€or€a€state€or€national€bank€having€trust€powers€in€Texas€and€is€willing€to€serve€as€trustee€of€theÏguardianship€management€trust€for€the€Wardððs€benefit;€that€the€Court€should€direct€that,€upon€creation€of€theÏguardianship€management€trust,€the€guardian€of€the€estate€of€the€Ward€and€each€person€holding€property€of€theÏWard€òò[including,€but€not€limited€to,€____________________________€(specifically€identify€third€partiesÐ –æ Ðholding€the€Wardððs€funds)]óó€shall€deliver€all€of€such€assets€to€Trustee,€to€be€held€by€Trustee€as€the€trust€estateÐ h¸ Ðof€the€trust;€that,€upon€creation€of€the€guardianship€management€trust€and€the€transfer€of€all€assets€in€theÏpossession€and€control€of€the€guardian€of€the€estate€of€the€Ward€to€the€Trustee,€no€guardianship€of€the€estate€ofÏthe€Ward€is€necessary€and€_____________€should€be€discharged€as€guardian€of€the€estate;€and€that€upon€entryÏof€the€Courtððs€order€creating€the€guardianship€management€trust,€_________________,€attorney€ad€litem,€shouldÏbe€paid€the€amount€stated€below€from€the€trust€as€a€reasonable€fee€for€serving€in€such€capacity€and€should€beÏdischarged.ÌÌà  àIT€IS,€THEREFORE,€ORDERED€that:ÌÌà  à1.à ` àA€guardianship€management€trust€for€the€benefit€of€the€Ward€is€established€pursuant€to€Tex.Ð œ$ì' ÐProb.€Code€Ann.€ðð867€with€the€terms€and€provisions€set€forth€on€Exhibit€ð ðAðð€attached€hereto€and€incorporatedÏherein;ÌÌà  àòò2.à ` à[It€is€in€the€best€interests€of€the€Ward€for€the€trust€to€be€a€supplemental€needs€trust€as€specifiedÐ ä'4#+ Ðunder€42€U.S.C.€Section€1396p(d)(4)(A),€and€the€terms€of€the€trust€instrument€attached€hereto€as€Exhibit€"A"Ïand€incorporated€herein€are€necessary€and€appropriate€for€the€Ward€to€be€eligible€to€receive€public€benefitsÏor€assistance€under€a€state€or€federal€program€that€is€not€otherwise€available€to€the€Ward;]óóÐ Z*ª%. ÐÌà  à3.à ` à€____________________________€("Trustee"),€a€trust€company€or€a€state€or€national€bankÐ þ+N'0 Ðhaving€trust€powers€in€Texas,€is€appointed€as€trustee€of€the€guardianship€management€trust€and€is€ordered€toÏadminister€such€trust€in€accordance€with€applicable€law€and€in€accordance€with€the€terms€and€provisions€of€theÐ ¢-ò(2 Ðtrust€instrument€attached€hereto€as€Exhibit€ð ðA;ððÌÌà  à4.à ` àThe€guardian€of€the€estate€of€the€Ward€and€each€person€holding€property€of€the€WardÐ T¤ Ðòò[including,€but€not€limited€to,€____________________________€(specifically€identify€third€parties€holding€theÐ &v ÐWardððs€funds)]óó€shall€deliver€all€of€such€assets€to€Trustee,€to€be€held€by€Trustee€as€the€trust€estate€of€the€trust;Ð øH ÐÌà  à5.à ` àUpon€creation€of€the€guardianship€management€trust€and€the€transfer€of€all€assets€in€theÐ œ ì Ðpossession€and€control€of€the€guardian€of€the€estate€of€the€Ward€to€the€Trustee,€no€guardianship€of€the€estate€ofÏthe€Ward€is€necessary€and€_____________€should€be€discharged€as€guardian€of€the€estateòò[;€andÐ @  ÐÌà  à6.à ` à______________________,€attorney€ad€litem,€is€awarded€a€fee€in€the€amount€ofÐ ä 4  Ð$_________________€from€the€trust€as€a€reasonable€fee€for€serving€in€such€capacity€and€is€hereby€discharged.]óóÐ ¶   ÐÌà  àSIGNED€this€____€day€of€______________,€_____.ÌÌÌ_________________________________________ÌJudge€PresidingÐ  ¢ò  Ðà@±±ìàò òÔ  ÔAPPENDIX€P€„„€Form€of€867€TrustÔ ~šÔó óÔ €ã ԈР° ÐÌÓC€ + ÿÿ$3CÓà@--%ìàò òNO.€______ˆÐ R¢ ÐÌGUARDIANSHIP€OF€THE€ESTATEà@¿¿*ìàððˆà0  àà0p(#(#àà0Èp(#p(#àIN€THE€PROBATE€COURTÐòBÈ(#È(# Ðà@¿¿*ìàððˆÌOF€________________________,à@¿¿*ìàððˆà0  àà0p(#(#àà0Èp(#p(#àà  à€€€€OFÐ’ âÈ(#È(# Ðà@¿¿*ìàððˆÌòò[A€MINOR][AN€INCAPACITATED€PERSON]óóà@¿¿*ìàððˆà0  àà0p(#(#àà0Èp(#p(#à____________€COUNTY,Ð 2 ‚ ÐTEXASó óÐ T È(#È(# ÐÌà@RRìàò òGUARDIANSHIP€MANAGEMENT€TRUST€FOR€_______________________ó óˆÐ ¦ ö  ÐÌà  àThis€declaration€of€trust€creates€a€management€trust€(the€"Trust")€for€the€benefit€ofÏ____________________€(the€"Beneficiary")€with€__________________€(the€"Trustee")€as€trustee.ÌÌà  àÔ2ÿÿÔÚ  Ú1Ú  Ú.Ô3  Ôà ` àò òAuthority€for€Creation.ó ó€€This€Trust€is€created€by€the€order€of€the€Probate€Court€ofÐ ¾  Ð_____________€County,€Texas€(the€"Court")€in€Cause€No.€_________,€Guardianship€of€the€Estate€of€theÏBeneficiary,€pursuant€to€Sections€867€„„€873€of€the€Texas€Probate€Code.ÌÌà  àÔ2ÿÿÔÚ  Ú2Ú  Ú.Ô3  Ôà ` àò òTransfer€to€Trust.ó óà h àThe€initial€trust€estate€of€the€Trust€shall€be€the€property€described€onÐ X ÐSchedule€"A"€attached€hereto.€€Additional€property€acceptable€to€the€Trustee€may€be€transferred€to€the€TrustÏfrom€time€to€time€and€added€to€the€trust€estate.ÌÌà  àÔ2ÿÿÔÚ  Ú3Ú  Ú.Ô3  Ôà ` àò òDistributions€During€Term€of€Trust.ó ó€€The€Beneficiary€shall€be€the€sole€beneficiary€of€theÐ R¢ ÐTrust.€€Prior€to€termination€of€the€Trust,€the€Trustee€may€disburse€that€amount€of€the€Trust's€principal€or€incomeÏas€the€Trustee€determines€is€necessary€to€expend€for€the€health,€education,€support,€or€maintenance€of€theÏBeneficiary.€€In€addition,€the€Trustee€may€make€a€distribution,€payment,€use,€or€application€of€trust€funds€for€theÏhealth,€education,€support,€or€maintenance€of€the€Beneficiary€or€of€another€person€whom€the€Beneficiary€isÏlegally€obligated€to€support,€as€necessary€and€without€the€intervention€of€a€guardian€or€other€representative€ofÏthe€Beneficiary,€to:€(A)€the€Beneficiaryððs€guardian;€(B)€a€person€who€has€physical€custody€of€the€BeneficiaryÏor€another€person€whom€the€Beneficiary€is€legally€obligated€to€support;€or€(C)€a€person€providing€a€good€orÏservice€to€the€Beneficiary€or€another€person€whom€the€Beneficiary€is€legally€obligated€to€support.€€The€incomeÏof€the€Trust€that€the€Trustee€does€not€disburse€under€this€section€must€be€added€to€the€principal€of€the€Trust.ÌÌà  àÔ2ÿÿÔÚ  Ú4Ú  Ú.Ô3  Ôà ` àò òTermination€of€Trust.ó ó€€The€Trust€will€terminate€on€the€earlier€of:€€(a)€the€death€of€theÐ Z!ª# ÐBeneficiary;€or€(b)€òò[on€the€Beneficiaryððs€eighteenth€(18th)€birthday,€unless€the€Court€orders€that€the€trust€shallÐ ."~$ Ðterminate€on€a€date€later€than€the€Beneficiaryððs€eighteenth€(18th)€birthday,€which€date€may€not€be€later€thanÏthe€Beneficiaryððs€twenty„fifth€(25th)€birthday][on€the€date€the€Court€determines€that€continuing€the€trust€is€noÏlonger€in€the€Beneficiaryððs€best€interests]óó.€€The€Trust€also€may€be€terminated€in€whole€or€in€part€at€any€time€byÐ ¤$ô' Ðorder€of€the€Court.ÌÌà  àÔ2ÿÿÔÚ  Ú5Ú  Ú.Ô3  Ôà ` àò òDistribution€Upon€Termination€of€Trust.€€ó óUpon€termination€of€the€Trust,€the€trustee€shallÐ 'j"* Ðprepare€and€file€the€final€account€required€by€Tex.€Prob.€Code€Ann.€ðð€873€and,€upon€approval€of€the€Court€andÏunless€otherwise€provided€by€the€Court,€shall€distribute€the€principal€and€any€undistributed€income€of€the€TrustÏto€the€Beneficiary,€outright€and€free€of€trust,€or,€if€the€Beneficiary€is€then€deceased,€to€the€representative€of€theÏdeceased€Beneficiaryððs€estate.ÌÌÔ*eƒª4«dd¤dd ¤…4¡°(#°(#eÔÔ,Âdd ÔÔ+  ÔÐ  ,X'0 €€Ðà@©©‘àò òIf€This€is€a€(d)(4)(A)€trust,€use€the€following€alternative€paragraphs€3.,€4.€and€5.€insteadó óˆÐ l,¼'1 ÐÐ <-Œ(2 Ðà l à3.à Ä àò òDistributions€During€Term€of€Trust.ó ó€€The€following€provisions€shall€govern€distributionsÐ d Ðfrom€the€Trust€during€the€term€of€this€Trust:ÌÌà l àà Ä àA.à  àò òPurpose€and€Intent.ó ó€€This€Trust€is€created€pursuant€to€42€U.€S.€C.€ðð1396p(d)(4)(A).€Ð ŒÜ ÐIt€is€intended€to€be€construed€and€administered€as€a€ð ðsupplemental€needsðð€trust€under€42€U.€S.€C.Ïðð1396p(d)(4)(A).€€Without€limiting€the€foregoing,€neither€the€corpus€of€the€Trust€nor€distributions€from€theÏTrust€shall€ever€cause€the€Beneficiary€to€be€disqualified€to€receive€those€public€benefits€or€assistance€under€aÏstate€or€federal€program€to€which€the€Beneficiary€then€may€be€entitled€but€for€the€existence€of€this€Trust€or€butÏfor€the€distributions€from€this€Trust.ÌÌà l àà Ä àB.à  àò òDistribution€Standard.ó ó€€During€the€term€of€this€Trust,€the€Trustee€shall€apply€for€theÐ L œ  Ðbenefit€of€the€Beneficiary€those€amounts€of€the€principal€and/or€income€of€the€Trust€for€the€satisfaction€of€theÏBeneficiaryððs€supplemental€needs€(defined€below),€as€the€Trustee,€in€the€Trustee's€sole€and€absolute€discretion,Ïmay€from€time€to€time€deem€appropriate,€subject€to€the€strict€limitations€set€out€in€this€instrument.€€€AnyÏincome€of€the€trust€not€distributed€shall€be€added€to€the€principal.€€The€Trustee€may€apply€such€trust€funds€forÏthe€benefit€of€the€Beneficiary,€as€necessary€and€without€the€intervention€of€a€guardian€or€other€representativeÏof€the€Beneficiary,€to:€(A)€the€Beneficiaryððs€guardian;€(B)€a€person€who€has€physical€custody€of€theÏBeneficiary;€or€(C)€a€person€providing€a€good€or€service€to€the€Beneficiary.€€ÌÌà l àà Ä àC.à  àò òSupplemental€Needs.€€ó óAs€used€in€this€instrument,€"supplemental€needs"€refers€to€theÐ ° Ðrequisites,€as€allowed€for€in€42€U.€S.€C.€ðð1396p(d)(4)(A),€for€maintaining€the€Beneficiaryððs€health,€safety,€andÏwelfare€when€the€Trustee€determines,€in€its€discretion,€that€such€needs€are€not€being€provided€for€by€anyÏpublic€or€private€agency,€including€any€state,€the€United€States,€or€any€insurance€carrier€with€insuranceÏpolicies€covering€the€Beneficiary.€€The€Trustee€is€prohibited€from€expending€any€of€the€trust€principal€orÏincome€for€any€property,€services,€benefits,€or€medical€care€which€are€being€received€by,€or€which€areÏotherwise€available€to,€the€Beneficiary€from€any€governmental€source€or€from€any€insurance€carrier€required€toÏcover€the€Beneficiary.€€Further,€the€Trustee€is€prohibited€from€expending€any€of€the€trust€principal€or€incomeÏfor€any€such€property,€services,€benefits,€or€medical€care€if€that€restriction€is€necessary€in€order€to€qualify€theÏBeneficiary€for€such€governmental€or€insurance€carrier€benefits€because€an€application€for€such€property,Ïservices,€benefits,€or€medical€care€has€been€filed€with€an€applicable€governmental€agency€or€insurance€carrierÏon€the€Beneficiary's€behalf.€€The€Trustee€may€pay€any€deductible€amounts€for€the€Beneficiary€on€any€insuranceÏpolicies€covering€the€Beneficiary€so€long€as€that€payment€does€not€disqualify€the€Beneficiary€from€receipt€ofÏbenefits.€€The€Trustee€shall€cooperate€with€the€Beneficiaryððs€conservator,€guardian,€or€legal€representative€toÏseek€support€and€maintenance€for€the€Beneficiary€from€all€available€resources,€including€but€not€limited€to,€theÏSupplemental€Social€Security€Income€Program€(SSI),€Supplemental€Income€Program€(SIP)€of€Texas,€the€OldÏAge€Survivor€and€Disability€Insurance€Program€(OASDI),€the€Medicaid€Program,€and€any€additional€similarÏor€successor€programs,€and€from€any€private€sources.€€To€the€extent€required€by€42€U.€S.€C.€ðð1396p(d)(4)(A)Ïand€other€applicable€laws€and€regulations€regarding€trusts€of€this€type,€the€Trustee€òòòòmay€supplement,€but€shallÐ v#Æ& Ðnot€supplantóó,óó€services,€benefits,€and€medical€care€received€or€requested€by€or€on€behalf€of€the€Beneficiary€thatÐ H$˜' Ðare€available€through€any€governmental€or€private€resource.ÌÌà l àà Ä àD.à  àò òPayment€of€Income€Taxes.ó ó€€The€Trustee€shall€pay€any€income€tax€liability€of€theÐ ¾&"* ÐBeneficiary€which€results€from€income€received€by€the€Trust€but€reported€on€the€income€tax€return€of€theÏBeneficiary.€€The€funds€used€to€pay€this€income€tax€liability€shall€be€paid€directly€to€the€appropriate€taxingÏauthority€and€shall€not€be€available€to€the€Beneficiary.€€The€Beneficiary€shall€not€have€any€right€to€or€interestÏin€any€of€these€funds€paid€by€the€Trustee.€€Further,€these€funds€are€not€a€resource€of€the€Beneficiary€and€shallÏnot€be€treated€as€a€distribution€of€cash€for€purposes€of€Medicaid€qualification.ÌÌà l à4.à Ä àò òTermination€of€Trust.ó ó€€The€Trust€will€terminate€on€the€death€of€the€Beneficiary.€€The€TrustÐ ~,Î'1 Ðalso€may€be€terminated€in€whole€or€in€part€at€any€time€by€order€of€the€Court.Ð R-¢(2 Їà l à5.à Ä àò òDistribution€Upon€Termination€of€Trust.€€ó óUpon€termination€of€the€Trust,€the€trustee€shallÐ d Ðdistribute€the€principal€and€any€undistributed€income€of€the€Trust€as€follows:Ìà l àÌà l àà Ä àA.à  àFirst,€the€Trustee€shall€pay€all€amounts€required€to€be€reimbursed€pursuant€to€42€U.Ð ŒÜ ÐS.€C.€ðð1396p(d)(4)(A).€€The€Trustee€shall€reimburse€those€states€where€the€Beneficiary€has€received€MedicalÏAssistance€payments€from€the€state,€based€upon€the€state's€proportionate€share€of€the€total€amount€of€MedicaidÏbenefits€paid€by€all€of€the€states€on€the€Beneficiaryððs€behalf,€the€smallest€amount€(if€any)€as€applicable€lawÏthen€requires€the€Trust€to€pay.€€The€Trustee's€duty€to€reimburse€the€state€upon€termination€shall€apply€to€theÏextent€there€are€remaining€assets€in€this€trust€and€shall€apply€irrespective€of€any€other€provision€of€thisÏinstrument.€€€The€Trustee€shall€reimburse€the€state€only€for€those€benefits€provided€to€the€Beneficiary€whichÏare€subject€to€such€reimbursement€claim.ÌÌà l àà Ä àB.à  àAfter€the€satisfaction€of€these€obligations,€the€Trustee€shall€distribute€the€remainingÐ î>  Ðproperty,€if€any,€to€the€Beneficiary,€outright€and€free€of€trust,€or,€if€the€Beneficiary€is€then€deceased,€to€theÏrepresentative€of€the€deceased€Beneficiaryððs€estate.Ð’â   ÐÌà  àÔ2ÿÿÔÚ  Ú6Ú  Ú.Ô3  Ôà ` àò òAnnual€Accountings.ó ó€€The€Trustee€shall€prepare€and€file€with€the€court€an€annual€accountingÐ f¶  Ðof€transactions€in€the€Trust€in€the€same€manner€and€form€that€is€required€of€a€guardian€of€the€estate€under€theÏTexas€Probate€Code.€€The€Trustee€shall€provide€a€copy€of€the€annual€account€to€the€Guardian€of€the€Beneficiary'sÏEstate€and€Person.€€The€annual€account€is€subject€to€review€and€approval€by€the€Court€in€the€same€manner€thatÏis€required€of€an€annual€account€prepared€by€a€guardian€of€the€estate€under€the€Texas€Probate€Code.ÌÌà  àÔ2ÿÿÔÚ  Ú7Ú  Ú.Ô3  Ôà ` àò òCompensation€of€the€Trustee.ó ó€€The€Trustee,€on€annual€application€to€the€Court€and€subjectÐ T¤ Ðto€the€Court's€approval,€is€entitled€to€receive€reasonable€compensation€for€services€that€the€Trustee€provided€toÏthe€Beneficiary€as€the€Beneficiary's€Trustee€that€is€(A)€to€be€paid€from€the€Trust's€income,€principal,€or€both€andÏ(B)€determined€in€the€same€manner€as€compensation€of€a€guardian€of€the€estate€under€Section€665€of€the€TexasÏProbate€Code;€provided,€however,€that€the€Trustee€shall€not€be€entitled€to€compensation€based€on€distributionsÏto€the€Guardian€of€the€Estate€of€the€Beneficiary€for€purposes€of€making€gifts€pursuant€to€Section€865€of€the€TexasÏProbate€Code.€€The€Trustee€may€be€reimbursed€from€the€trust€estate€for€expenses€it€reasonably€incurs€with€theÏapproval€of€the€Court.ÌÌà  àÔ2ÿÿÔÚ  Ú8Ú  Ú.Ô3  Ôà ` àò òPowers€of€Trustee.ó ó€€The€Trustee€shall€have€all€of€the€powers€of€trustees€under€the€Texas€TrustÐ ¸ ÐCode.€€The€Trustee€may€invest€the€trust€estate€in€investments€permitted€under€the€Texas€Trust€Code€withoutÏfurther€order€of€the€Court€and€is€not€required€to€invest€the€trust€estate€in€investments€permitted€by€Section€855Ïof€the€Texas€Probate€Code.€€The€terms€and€provisions€of€the€Texas€Trust€Code€shall€apply€to€this€Trust,€to€theÏextent€they€are€not€in€conflict€with€Tex.€Prob.€Code€Ann.€ðððð€867„873€or€with€the€terms€of€this€instrument.ÌÌà  àÔ2ÿÿÔÚ  Ú9Ú  Ú.Ô3  Ôà ` àò òNo€Bond€Required.ó ó€€The€Trustee€shall€serve€without€giving€a€bond.€€Neither€the€Guardian€ofÐ ¦#ö% Ðthe€Estate€of€the€Beneficiary€nor€the€surety€on€the€Guardian's€bond€(if€any)€shall€be€liable€for€an€act€or€omissionÏof€the€Trustee.ÌÌà  àÔ2ÿÿ ÔÚ  Ú10Ú  Ú.Ô3  Ôà ` àò òSuccessor€Trustees.ó ó€€In€the€event€of€the€corporate€reorganization,€merger€or€acquisition€of€theÐ ð&@") ÐTrustee,€the€resulting€successor€organization€shall€automatically€become€the€successor€trustee.€€The€Trustee€mayÏresign€with€the€approval€of€the€Court€and€may€be€removed€by€order€of€the€Court.€€Upon€the€resignation€orÏremoval€of€the€Trustee,€the€Court€shall€appoint€a€successor€trustee.€€Each€successor€trustee€shall€have€all€of€theÏrights,€powers€and€duties€of€the€Trustee.ÌÌà  àÔ2ÿÿ ÔÚ  Ú11Ú  Ú.Ô3  Ôà ` àò òSpendthrift€Trust.ó ó€€To€the€extent€permitted€by€law,€the€interest€of€the€Beneficiary€shall€be€heldÐ Þ+.'/ Ðsubject€to€a€spendthrift€trust€as€provided€in€Section€112.035€of€the€Texas€Property€Code.ÌÔ_ÔÐ „-Ô(1 Ðà  àÔ2ÿÿ ÔÚ  Ú12Ú  Ú.Ô3  Ôà ` àò òAmendment,€Modification€or€Revocation.ó ó€€The€Court€may€amend,€modify,€or€revoke€the€TrustÐ ° Ðat€any€time€before€the€date€of€the€Trust's€termination.€€Neither€the€Beneficiary€nor€the€guardian€of€theÏBeneficiary's€estate€may€revoke€the€Trust.ÌÌà  àÔ2ÿÿ ÔÚ  Ú13Ú  Ú.Ô3  Ôà ` àò òEffective€Date.ó ó€€€This€Trust€shall€be€effective€upon€the€last€to€occur€of€(A)€the€entry€of€an€orderÐ úJ Ðcreating€the€Trust€by€the€Court,€(B)€the€execution€of€this€Declaration€of€Trust€by€the€Trustee€indicating€itsÏacceptance€of€the€Trust;€and€(C)€the€receipt€by€the€Trustee€of€the€initial€trust€estate.ÌÌTRUSTEE'S€ACCEPTANCE:ÌBy:_______________________ÌName:_____________________ÌTitle:______________________Ð  º  Ðà@´ ´ ìàññññññññò òÔ  ÔññññññññAPPENDIX€Q€ð"ð€Supplemental€Needs€Trust€Created€by€Third€PartyññññññññÔ ×Ôó óÔ €ä ÔññññññññÌññññÌññññññÔ_ÔÔ*‹ƒ4‚ddd Xdd Xdd X°(#°(#‹ÔÔ,¤dd ÔÔ+  ÔÐ  ° ÐThis€is€not€a€court„created€trust,€nor€does€it€meet€the€requirements€of€42€U.€S.€C.Ïðð1396p(d)(4)(A).€€Rather,€this€is€a€form€of€trust€which€may€be€used€by€a€parent€orÏother€relative€as€a€means€of€transferring€property€from€the€parent€or€relative€for€theÏbenefit€of€a€person€receiving€governmental€assistance€without€disqualifying€thatÏperson€from€receiving€such€assistance.€€The€most€significant€distinction€between€thisÏtrust€and€a€(d)(4)(A)€trust€is€that€this€trust€contains€no€provision€for€reimbursing€theÏstate€upon€the€death€of€the€beneficiary,€since€reimbursement€is€not€required€for€aÏtrust€holding€a€third€partyððs€funds€(rather€than€the€beneficiaryððs€funds).Ð ¤ ô Ðò òÌà@ ìàSUPPLEMENTAL€NEEDS€TRUST€FOR€__________________ó óˆÐ ´   ÐÌà  àThis€trust€agreement€is€made€by€and€between€____________________€(ð ðSettlorðð)Ïas€settlor€and€__________________€(ð ðTrusteeðð)€as€trustee€in€order€to€create€a€trust€(theÏð ðTrustðð)€for€the€primary€benefit€of€_____________€(ð ðBeneficiaryðð).ÌÌÝ ‚é; ÝÝ  ÝÝ‚é;ÊÜÝà0  àÔ2#ÔÚ  ÚaÚ  Ú.Ô3  Ôà0` (#(#àÝ  Ýà ¸ àò òTransfer€to€Trust.ó óà À àSettlor€transfers€to€Trustee€the€propertyÐ T¤ Ðdescribed€on€Schedule€"A"€attached€hereto€as€the€initial€trust€estate€ofÏthe€Trust.€€The€Trustee€accepts€such€property.€€Additional€propertyÏacceptable€to€the€Trustee€may€be€transferred€to€the€Trust€from€time€toÏtime€by€anyone€and€added€to€the€trust€estate.݃é;ÊÜõÜ݌Р` (#` (# ÐŒÝ  Ýà  àÌà  àòò[2.à ` àò òTrust€Irrevocable.ó ó€€This€trust€is€irrevocable.][2.€€ò òTrust€Revocable.ó ó€€ThisÐ ôD Ðtrust€may€be€revoked€or€amended€in€whole€or€in€part€by€Settlor€during€SettlorððsÏlifetime.€€After€Settlorððs€death,€this€Trust€shall€become€irrevocable.]óóÐ Ô$ ÐÌà  à3.à ` àò òDistributions€During€Term€of€Trust.ó ó€€The€following€provisions€shall€governÐ ´ Ðdistributions€from€the€Trust€during€the€term€of€this€Trust:ÌÌà  àà ` àA.à ¸ àò òPurpose€and€Intent.ó ó€€This€Trust€is€intended€to€be€construed€andÐ „Ô Ðadministered€as€a€ð ðsupplemental€needsðð€trust.€€Without€limiting€the€foregoing,€neitherÏthe€corpus€of€the€Trust€nor€distributions€from€the€Trust€shall€ever€cause€the€BeneficiaryÏto€be€disqualified€to€receive€those€public€benefits€or€assistance€under€a€state€or€federalÏprogram€to€which€the€Beneficiary€then€may€be€entitled€but€for€the€existence€of€thisÏTrust€or€but€for€the€distributions€from€this€Trust.ÌÌà  àà ` àB.à ¸ àò òDistribution€Standard.ó ó€€During€the€term€of€this€Trust,€the€TrusteeÐ &d!# Ðshall€apply€for€the€benefit€of€the€Beneficiary€those€amounts€of€the€principal€and/orÏincome€of€the€Trust€for€the€satisfaction€of€the€Beneficiaryððs€supplemental€needsÏ(defined€below),€as€the€Trustee,€in€the€Trustee's€sole€and€absolute€discretion,€mayÏfrom€time€to€time€deem€appropriate,€subject€to€the€strict€limitations€set€out€in€thisÏinstrument.€€€Any€income€of€the€trust€not€distributed€shall€be€added€to€the€principal.ÌÌà  àà ` àC.à ¸ àò òSupplemental€Needs.€€ó óAs€used€in€this€instrument,€"supplementalÐ ¤,ô'* Ðneeds"€refers€to€the€requisites€for€maintaining€the€Beneficiaryððs€health,€safety,€andÐ ”-ä(+ Ðwelfare€when€the€Trustee€determines,€in€its€discretion,€that€such€needs€are€not€beingÏprovided€for€by€any€public€or€private€agency,€including€any€state,€the€United€States,Ïor€any€insurance€carrier€with€insurance€policies€covering€the€Beneficiary.€à Ð àTheÐ à ÐTrustee€is€prohibited€from€expending€any€of€the€trust€principal€or€income€for€anyÏproperty,€services,€benefits,€or€medical€care€which€are€being€received€by,€or€which€areÏotherwise€available€to,€the€Beneficiary€from€any€governmental€source€or€from€anyÏinsurance€carrier€required€to€cover€the€Beneficiary.€€Further,€the€Trustee€is€prohibitedÏfrom€expending€any€of€the€trust€principal€or€income€for€any€such€property,€services,Ïbenefits,€or€medical€care€if€that€restriction€is€necessary€in€order€to€qualify€theÏBeneficiary€for€such€governmental€or€insurance€carrier€benefits€because€an€applicationÏfor€such€property,€services,€benefits,€or€medical€care€has€been€filed€with€an€applicableÏgovernmental€agency€or€insurance€carrier€on€the€Beneficiary's€behalf.€€The€Trustee€mayÏpay€any€deductible€amounts€for€the€Beneficiary€on€any€insurance€policies€covering€theÏBeneficiary€so€long€as€that€payment€does€not€disqualify€the€Beneficiary€from€receiptÏof€benefits.€€The€Trustee€shall€cooperate€with€the€Beneficiaryððs€conservator,€guardian,Ïor€legal€representative€to€seek€support€and€maintenance€for€the€Beneficiary€from€allÏavailable€resources,€including€but€not€limited€to,€the€Supplemental€Social€SecurityÏIncome€Program€(SSI),€Supplemental€Income€Program€(SIP)€of€Texas,€the€Old€AgeÏSurvivor€and€Disability€Insurance€Program€(Ô_ÔOASDIÔ_Ô),€the€Medicaid€Program,€and€anyÏadditional€similar€or€successor€programs,€and€from€any€private€sources.€€The€TrusteeÐ €Ð Ðòòòòmay€supplement,€but€shall€not€supplantóó,óó€services,€benefits,€and€medical€care€receivedÐ pÀ Ðor€requested€by€or€on€behalf€of€the€Beneficiary€that€are€available€through€anyÏgovernmental€or€private€resource.Ìà  àà ` àà ¸ àÌà  àà ` àD.à ¸ àò òPayment€of€Income€Taxes.ó ó€€The€Trustee€shall€pay€any€income€taxÐ 0€ Ðliability€of€the€Beneficiary€which€results€from€income€received€by€the€Trust€but€reportedÏon€the€income€tax€return€of€the€Beneficiary.€€The€funds€used€to€pay€this€income€taxÏliability€shall€be€paid€directly€to€the€appropriate€taxing€authority€and€shall€not€beÏavailable€to€the€Beneficiary.€€The€Beneficiary€shall€not€have€any€right€to€or€interest€inÏany€of€these€funds€paid€by€the€Trustee.€€Further,€these€funds€are€not€a€resource€of€theÏBeneficiary€and€shall€not€be€treated€as€a€distribution€of€cash€for€purposes€of€MedicaidÏqualification.ÌÌà  à4.à ` àò òFacility€of€Payment.ó ó€€Notwithstanding€anything€to€the€contrary€in€thisÐ  #ð! Ðinstrument,€the€Trustee,€in€its€sole€discretion,€may€make€any€distribution€required€orÏpermitted€to€be€made€under€this€instrument€in€any€of€the€following€ways€(regardlessÏof€whether€or€not€the€Beneficiary€is€a€minor€or€is€incapacitated):€(a)€To€the€BeneficiaryÏdirectly;€(b)€To€the€guardian€of€the€Beneficiaryððs€person€or€estate;€(c)€By€reimbursingÏthe€person€who€is€actually€taking€care€of€the€Beneficiary,€even€though€the€person€isÏnot€the€legal€guardian,€for€expenditures€made€by€the€person€for€the€benefit€of€theÏBeneficiary;€or€(d)€By€paying€for€a€good€or€service€directly€to€the€provider€of€that€goodÏor€service.ÌÌà  à5.à ` àò òTermination€of€Trust.ó ó€€The€Trust€will€terminate€on€the€death€of€theÐ -P(+ ÐBeneficiary.Ð ð-@), Їà  à6.à ` àò òDistribution€Upon€Termination€of€Trust.€€ó óUpon€termination€of€the€Trust,Ð ° Ðthe€trustee€shall€distribute€the€principal€and€any€undistributed€income€of€the€Trust€toÏthe€Beneficiaryððs€descendants,€per€stirpes,€and€if€the€Beneficiary€has€no€descendantsÏwho€are€then€living,€to€Settlorððs€descendants,€per€stirpes,€and€if€none€of€such€personsÏis€then€living,€to€Settlorððs€heirs€at€law.ÌÌà  à7.à ` àò òCompensation€of€the€Trustee.ó ó€€The€Trustee€shall€be€entitled€to€reasonableÐ P   Ðcompensation,€which€compensation€shall€not€exceed€that€customarily€charged€byÏcorporate€fiduciaries€in€____________,€Texas.€€In€addition,€the€Trustee€may€beÏreimbursed€from€the€trust€estate€for€expenses€it€reasonably€incurs.ÌÌà  à8.à ` àò òPowers€of€Trustee.ó ó€€The€Trustee€shall€have€all€of€the€powers€of€trusteesÐ P  Ðunder€the€Texas€Trust€Code.€€The€terms€and€provisions€of€the€Texas€Trust€Code€shallÏapply€to€this€Trust,€to€the€extent€they€are€not€in€conflict€with€the€terms€of€thisÏinstrument.ÌÌà  à9.à ` àò òNo€Bond€Required.ó ó€€The€Trustee€shall€serve€without€giving€a€bond.Ð ° ÐÌà  à10.à ` àò òSuccessor€Trustees.ó ó€€If€the€Trustee€resigns,€________________€shallÐ à Ðbecome€successor€Trustee.€€Each€successor€trustee€shall€have€all€of€the€rights,€powersÏand€duties€of€the€Trustee.ÌÌà  à11.à ` àò òSpendthrift€Trust.ó ó€€To€the€extent€permitted€by€law,€the€interest€of€theÐ P  ÐBeneficiary€shall€be€held€subject€to€a€spendthrift€trust€as€provided€in€Section€112.035Ïof€the€Texas€Property€Code.ÌÌà  àSigned€this€____€day€of€_____________,€____.ÌÌ___________________________________ÌSettlorÌÌ___________________________________ÌTrusteeññññññÔ#†Ô£v‹s#ÔÔ#†XbXÔ£¶#Ôññññ