Irrevocable Burial Trust

IRREVOCABLE BURIAL TRUST AGREEMENT

IMPORTANT NOTICES

MEDICAID PLANNING NOTICE: This Irrevocable Burial Trust is designed to set aside funds for funeral and burial expenses in a manner that may be exempt from Medicaid's asset limits. The rules regarding burial trusts vary by state, including:

• Maximum exempt amounts (typically $1,500 to $15,000)
• Required irrevocability
• Permitted expenses
• State-specific requirements

Consult with an elder law attorney to ensure compliance with your state's Medicaid rules.

TAX NOTICE: Interest earned on trust funds may be taxable income. Consult with a tax professional.

TRUST AGREEMENT

This Irrevocable Burial Trust Agreement ("Trust" or "Agreement") is entered into as of [DATE] ("Effective Date").

PARTIES

GRANTOR/SETTLOR:

Name: _______________________________________________

Address: _______________________________________________

Date of Birth: _______________________________________________

Social Security Number: _______________________________________________

(hereinafter referred to as "Grantor" or "Beneficiary")

TRUSTEE:

Name: _______________________________________________

Address: _______________________________________________

Phone: _______________________________________________

(hereinafter referred to as "Trustee")

RECITALS

WHEREAS, the Grantor desires to set aside funds for the Grantor's funeral, burial, and related expenses;

WHEREAS, the Grantor wishes to create an irrevocable trust that will be exempt from being counted as an available resource for purposes of Medicaid and other means-tested government benefit programs;

WHEREAS, the Grantor understands and intends that this Trust be irrevocable and that the funds cannot be withdrawn for any purpose other than the Grantor's funeral and burial expenses;

NOW, THEREFORE, the Grantor hereby declares and establishes this Irrevocable Burial Trust as follows:

ARTICLE 1: CREATION AND FUNDING OF TRUST

1.1 Creation of Trust

The Grantor hereby creates and establishes this Irrevocable Burial Trust for the purpose of providing funds for the Grantor's funeral, burial, and related final expenses.

1.2 Initial Funding

The Grantor transfers to the Trustee the sum of $_______________________________________________
to be held in trust pursuant to the terms of this Agreement.

1.3 Additional Contributions

☐ Additional contributions to this Trust are permitted up to the maximum amount allowed under applicable law.

☐ No additional contributions are permitted after the initial funding.

1.4 Maximum Funding

The total principal of this Trust shall not exceed $_______________________________________________
(or such other maximum amount as may be permitted under applicable state law for Medicaid-exempt burial trusts).

ARTICLE 2: IRREVOCABILITY

2.1 Express Irrevocability

This Trust is expressly and permanently IRREVOCABLE. The Grantor hereby relinquishes all right, title, and interest in the Trust funds and shall have no power to:

(a) Revoke, terminate, or modify this Trust;
(b) Withdraw any principal or income from this Trust;
(c) Change the Trustee or beneficiaries;
(d) Direct the investment of Trust assets; or
(e) Use the Trust funds for any purpose other than funeral and burial expenses.

2.2 Purpose of Irrevocability

The Grantor understands that the irrevocable nature of this Trust is essential to its treatment as a non-countable asset for Medicaid and other government benefit eligibility purposes.

2.3 No Amendment

This Trust may not be amended, modified, or altered in any way that would affect its irrevocable nature or its treatment as a Medicaid-exempt asset.

ARTICLE 3: PURPOSE AND USE OF FUNDS

3.1 Sole Purpose

The Trust funds shall be used SOLELY for the funeral, burial, and related final expenses of the Grantor, including but not limited to:

Funeral Service Expenses:
☐ Funeral director services
☐ Preparation of the body (embalming, preparation)
☐ Viewing/visitation facilities and services
☐ Funeral ceremony
☐ Memorial service
☐ Hearse and other vehicles
☐ Staff services
☐ Death certificates

Burial/Disposition Expenses:
☐ Cemetery plot or crypt
☐ Opening and closing of grave
☐ Casket or burial container
☐ Outer burial container (vault)
☐ Cremation and urn
☐ Mausoleum crypt
☐ Columbarium niche

Memorialization:
☐ Headstone, marker, or monument
☐ Engraving
☐ Perpetual care

Other Permitted Expenses:
☐ Flowers
☐ Music
☐ Clergy honorarium
☐ Transportation of remains
☐ Prayer cards, memorial folders
☐ Death notices/obituary
☐ Other customary funeral expenses

3.2 Prohibited Uses

Trust funds may NOT be used for:

(a) Living expenses of the Grantor
(b) Medical care
(c) Any purpose other than funeral and burial expenses
(d) Payment to the Grantor or the Grantor's estate (except for reimbursement of funeral expenses)

ARTICLE 4: TRUSTEE PROVISIONS

4.1 Initial Trustee

The initial Trustee is _______________________________________________

4.2 Successor Trustee

If the initial Trustee is unable or unwilling to serve, the following shall serve as successor Trustee:

First Successor: _______________________________________________

Second Successor: _______________________________________________

4.3 Trustee Duties

The Trustee shall:

(a) Hold and invest the Trust funds prudently;
(b) Maintain the funds in an interest-bearing account;
(c) Pay funeral and burial expenses upon the Grantor's death in accordance with this Agreement;
(d) Maintain records of all transactions;
(e) Provide accountings as required by law or upon reasonable request.

4.4 Trustee Powers

The Trustee shall have the following powers:

(a) To open and maintain bank accounts in the name of the Trust;
(b) To invest Trust funds in savings accounts, certificates of deposit, money market accounts, or other conservative investments;
(c) To pay reasonable Trustee fees and Trust administration expenses from Trust income;
(d) To employ professionals as necessary for Trust administration.

4.5 Trustee Compensation

☐ The Trustee shall serve without compensation.

☐ The Trustee shall be entitled to reasonable compensation of $____________ per year, payable from Trust income.

4.6 Trustee Liability

The Trustee shall not be liable for any loss to the Trust except for losses caused by the Trustee's own gross negligence or willful misconduct.

ARTICLE 5: DISTRIBUTION UPON DEATH

5.1 Payment of Funeral Expenses

Upon the death of the Grantor, the Trustee shall:

(a) Pay the costs of the Grantor's funeral, burial, and related expenses directly to the providers of such services;
(b) Reimburse any person who has advanced funds for such expenses;
(c) Make such payments promptly upon receipt of invoices or other documentation.

5.2 Funeral Home Instructions

The Grantor has ☐ has not ☐ entered into a pre-need agreement with a funeral home:

Funeral Home: _______________________________________________

Address: _______________________________________________

Phone: _______________________________________________

Agreement Number: _______________________________________________

5.3 Order of Priority for Payments

Funeral and burial expenses shall be paid in the following order of priority:

1. Funeral home charges
2. Cemetery/crematory charges
3. Monument/marker
4. Other customary expenses

5.4 Excess Funds

If any Trust funds remain after all funeral and burial expenses have been paid:

☐ Remaining funds shall be paid to the State Medicaid agency to the extent of any Medicaid benefits paid on behalf of the Grantor.

☐ Remaining funds shall be distributed to: _______________________________________________

☐ Remaining funds shall be distributed to the Grantor's estate.

[NOTE: State Medicaid rules may require that excess funds be paid to the state. Verify your state's requirements.]

5.5 Insufficient Funds

If the Trust funds are insufficient to pay all funeral and burial expenses, the Trustee is not obligated to pay the excess. The responsibility for any shortfall shall rest with the Grantor's estate or other responsible parties.

ARTICLE 6: INVESTMENT AND ACCOUNTING

6.1 Investment Standard

The Trustee shall invest Trust funds in safe, interest-bearing accounts or instruments, with preservation of principal as the primary objective.

6.2 Permitted Investments

Trust funds may be invested in:

(a) FDIC-insured savings accounts
(b) FDIC-insured certificates of deposit
(c) Money market accounts
(d) U.S. Treasury securities
(e) Other conservative investments approved by law

6.3 Income

All income earned on Trust funds shall be added to and become part of the Trust principal, to be used for the same purposes as the original Trust funds.

6.4 Accounting

The Trustee shall maintain accurate records of all Trust transactions and shall provide an accounting:

(a) Annually to the Grantor or Grantor's legal representative;
(b) Upon termination of the Trust;
(c) Upon request by any state agency with authority over the Trust.

ARTICLE 7: MEDICAID COMPLIANCE

7.1 Intent

It is the Grantor's intent that this Trust qualify as an exempt asset for purposes of Medicaid and other means-tested government benefit programs. All provisions of this Trust shall be construed to effectuate this intent.

7.2 Irrevocability for Medicaid Purposes

The Grantor acknowledges that:

(a) This Trust is irrevocable and cannot be cancelled;
(b) The Trust funds are not available to the Grantor for any purpose other than funeral and burial expenses;
(c) The Trust funds may not be counted as an available resource for Medicaid eligibility purposes (subject to state limits);
(d) The Trust is not subject to the Medicaid lookback period for asset transfers.

7.3 State Law Compliance

This Trust shall be administered in compliance with all applicable state laws regarding burial trusts, including any maximum funding limits, required provisions, or reporting requirements.

7.4 State Limits

The Grantor acknowledges that state law may limit the amount that can be held in an exempt burial trust. If the Trust is funded in excess of the state limit, the excess may be counted as an available resource for Medicaid purposes.

State Maximum (if applicable): $_______________________________________________

ARTICLE 8: GENERAL PROVISIONS

8.1 Governing Law

This Trust shall be governed by the laws of the State of _______________________________________________.

8.2 Situs

The situs of this Trust shall be _______________________________________________.

8.3 Severability

If any provision of this Trust is held invalid or unenforceable, the remaining provisions shall continue in full force and effect.

8.4 Headings

Article and section headings are for convenience only and shall not affect interpretation.

8.5 Entire Agreement

This document constitutes the entire agreement regarding the Trust and supersedes all prior agreements or understandings.

8.6 Spendthrift

The Trust funds shall not be subject to the claims of creditors of the Grantor or the Trustee, nor shall they be subject to anticipation, alienation, or assignment.

ARTICLE 9: TRUST TERMINATION

9.1 Termination Event

This Trust shall terminate upon the earlier of:

(a) Payment of all funeral and burial expenses of the Grantor; or
(b) Distribution of all Trust assets in accordance with this Agreement.

9.2 Final Accounting

Upon termination, the Trustee shall provide a final accounting of all Trust transactions.

EXECUTION

IN WITNESS WHEREOF, the Grantor and the Trustee have executed this Irrevocable Burial Trust Agreement as of the date first written above.

GRANTOR:

Signature: _______________________________________________

Printed Name: _______________________________________________

Date: _______________________________________________

TRUSTEE:

I accept appointment as Trustee of this Irrevocable Burial Trust and agree to administer it in accordance with its terms.

Signature: _______________________________________________

Printed Name: _______________________________________________

Date: _______________________________________________

NOTARY ACKNOWLEDGMENT

STATE OF _______________
COUNTY OF _______________

On this ___ day of _____________, 20___, before me personally appeared:

_______________________________________________ (Grantor)

_______________________________________________ (Trustee)

known to me (or proved to me on the basis of satisfactory evidence) to be the persons whose names are subscribed to the within instrument and acknowledged to me that they executed the same in their authorized capacities, and that by their signatures on the instrument the persons, or the entity upon behalf of which the persons acted, executed the instrument.

WITNESS my hand and official seal.

_______________________________________________
Notary Public

My Commission Expires: _______________________________________________

[NOTARY SEAL]

SCHEDULE A: INITIAL TRUST PROPERTY

The following property is hereby transferred to the Trustee:

Cash: $_______________________________________________

Check Number: _______________________________________________

Bank: _______________________________________________

Date Deposited: _______________________________________________

SCHEDULE B: FUNERAL AND BURIAL PREFERENCES

(Optional - The Grantor may attach specific funeral and burial instructions)

☐ See attached Funeral Pre-Planning Declaration

☐ See attached Burial Instructions

☐ The Grantor's preferences are:

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

RECEIPT AND ACCEPTANCE BY TRUSTEE

I, _______________________________________________, acknowledge receipt of:

☐ The sum of $_______________________________________________

☐ The original signed Trust Agreement

I accept my appointment as Trustee of this Irrevocable Burial Trust and agree to hold and administer the Trust funds in accordance with the terms of this Agreement.

Trustee Signature: _______________________________________________

Date: _______________________________________________

This template is provided for informational purposes only and does not constitute legal advice. Irrevocable burial trusts have significant legal and Medicaid implications. State laws regarding burial trusts vary considerably, including maximum exempt amounts, required provisions, and reporting requirements. Consult with a qualified elder law attorney in your state before creating an irrevocable burial trust.