MISSOURI SPECIAL NEEDS TRUST AGREEMENT

Comprehensive Template — First-Party and Third-Party Provisions

IMPORTANT NOTICE TO DRAFTING ATTORNEY: This template contains provisions for both third-party and first-party (self-settled) special needs trusts. Select the appropriate provisions based on the source of trust funding. First-party trusts funded with the beneficiary's own assets require a Medicaid payback provision under 42 U.S.C. § 1396p(d)(4)(A). Third-party trusts funded exclusively by persons other than the beneficiary do not. All bracketed fields must be completed and all optional provisions must be selected before execution. This document must be reviewed for compliance with current MO HealthNet requirements, SSA policy (POMS), and Missouri Uniform Trust Code provisions.

TABLE OF CONTENTS

1. Trust Identification and Parties
2. Recitals and Purpose
3. Definitions
4. Trust Type Selection
5. Creation, Irrevocability, and Governing Law
6. Trust Estate and Funding
7. Distribution Standards — Supplemental Needs
8. Prohibited Distributions and Benefit Preservation
9. Spendthrift Provisions
10. Medicaid Payback Provision (First-Party Trust Only)
11. ABLE Account Coordination
12. Trustee Powers
13. Trust Protector / Advisory Committee
14. Accountings, Reports, and Informational Rights
15. Trustee Compensation and Reimbursement
16. Successor Trustee Provisions
17. Trust Termination and Remainder Beneficiaries
18. Tax Provisions
19. Amendment and Judicial Modification
20. General Provisions
21. Execution
22. Schedules

ARTICLE 1. TRUST IDENTIFICATION AND PARTIES

1.1 Trust Name

This trust shall be known as the [________________________________] Special Needs Trust (the "Trust").

1.2 Effective Date

This Missouri Special Needs Trust Agreement (the "Trust Agreement" or "Agreement") is executed and effective as of [__/__/____] (the "Effective Date").

1.3 Parties

The parties to this Agreement are:

(a) Settlor/Grantor:

(b) Trustee:

(c) Beneficiary:

ARTICLE 2. RECITALS AND PURPOSE

2.1 Recitals

WHEREAS, Settlor desires to establish an irrevocable trust for the primary benefit of Beneficiary, who has a disability as defined under Section 1614(a)(3) of the Social Security Act (42 U.S.C. § 1382c(a)(3));

WHEREAS, Beneficiary currently receives, or is expected to receive, means-tested government benefits, including but not limited to Supplemental Security Income ("SSI") and Missouri Medicaid through the MO HealthNet program administered by the Missouri Department of Social Services, Family Support Division;

WHEREAS, it is Settlor's primary and overriding intent that this Trust shall serve as a "supplemental needs trust" or "special needs trust" that supplements but does not supplant, replace, or diminish any government benefits for which Beneficiary is or may become eligible;

WHEREAS, Settlor intends that this Trust comply with all applicable provisions of:
- The Missouri Uniform Trust Code, RSMo §§ 456.1-101 to 456.11-1106;
- Federal Medicaid law, 42 U.S.C. § 1396p(d)(4)(A) (if a first-party trust);
- Social Security Administration Program Operations Manual System (POMS), including POMS SI 01120.203; and
- All applicable regulations of the Missouri Department of Social Services;

WHEREAS, Trustee is willing to accept the trust and administer it in accordance with the terms herein;

NOW, THEREFORE, in consideration of the mutual covenants and for the purpose of providing supplemental care and services for Beneficiary, Settlor hereby transfers and delivers to Trustee the property described in Schedule A attached hereto (the "Initial Trust Property"), to be held, managed, invested, and distributed as set forth in this Agreement.

2.2 Statement of Intent

The Settlor's intent in creating this Trust is to enhance the quality of life of Beneficiary by providing goods, services, and experiences that supplement those provided by government benefits programs, without jeopardizing Beneficiary's eligibility for such programs. This statement of intent shall be the primary guide for Trustee in exercising all discretionary powers under this Agreement. In the event of any ambiguity in the Trust provisions, Trustee and any reviewing court shall construe the Trust in a manner that preserves Beneficiary's eligibility for government benefits.

ARTICLE 3. DEFINITIONS

For purposes of this Agreement, the following capitalized terms shall have the meanings set forth below:

"ABLE Account" means a qualified ABLE program account established under 26 U.S.C. § 529A and the Missouri ABLE program (MO ABLE), or any successor program.

"Authorized Distributions" means distributions permitted under Article 7 of this Agreement.

"Beneficiary" means the individual identified in Section 1.3(c).

"Corpus" or "Trust Estate" means all property held in trust from time to time, including the Initial Trust Property, all additions, all income, gains, and appreciation, whether realized or unrealized.

"First-Party Trust" means a special needs trust funded in whole or in part with assets belonging to Beneficiary, subject to the requirements of 42 U.S.C. § 1396p(d)(4)(A).

"Government Benefits" means any and all federal, state, or local means-tested or need-based public assistance programs, including but not limited to SSI, Medicaid (MO HealthNet), Section 8/HUD housing assistance, SNAP (food stamps), and any successor programs.

"In-Kind Support and Maintenance" ("ISM") means food and shelter, as defined under 20 C.F.R. § 416.1130, including mortgage payments, real property taxes and insurance, rent, heating fuel, gas, electricity, water, sewer, and garbage removal.

"MO HealthNet" means the Missouri Medicaid program administered by the Missouri Department of Social Services, MO HealthNet Division, pursuant to Title XIX of the Social Security Act.

"POMS" means the Social Security Administration's Program Operations Manual System, as updated from time to time.

"Protected Period" means any period during which Beneficiary receives or is eligible for Government Benefits.

"Remainder Beneficiary" or "Remainder Beneficiaries" means the person(s) or entity(ies) designated in Article 17 to receive the Trust Estate upon termination.

"Settlor" means the individual identified in Section 1.3(a).

"Special Needs" or "Supplemental Needs" means the needs of Beneficiary that are not being met by Government Benefits, including but not limited to those items and services described in Section 7.2.

"Third-Party Trust" means a special needs trust funded exclusively with assets that have never belonged to Beneficiary.

"Trust Protector" means the individual or entity appointed under Article 13.

"Trustee" means the individual or entity identified in Section 1.3(b) and any successor appointed under Article 16.

ARTICLE 4. TRUST TYPE SELECTION

DRAFTING INSTRUCTION: Select one of the following. The choice determines whether the Medicaid payback provision in Article 10 applies.

☐ OPTION A — THIRD-PARTY SPECIAL NEEDS TRUST. This Trust is funded exclusively with assets belonging to persons other than Beneficiary. No assets of Beneficiary have been or shall be contributed to this Trust. The Medicaid payback provision in Article 10 does NOT apply. This Trust is not subject to 42 U.S.C. § 1396p(d)(4)(A).

☐ OPTION B — FIRST-PARTY (SELF-SETTLED) SPECIAL NEEDS TRUST. This Trust is funded in whole or in part with assets belonging to Beneficiary (including but not limited to personal injury settlements or judgments, inheritances, or retroactive benefit payments). This Trust is established pursuant to 42 U.S.C. § 1396p(d)(4)(A) and must comply with all requirements thereof. The Medicaid payback provision in Article 10 DOES apply. This Trust must be established by a parent, grandparent, legal guardian, or court for the benefit of a disabled individual under age 65 at the time of trust establishment.

If Option B is selected, complete the following:

ARTICLE 5. CREATION, IRREVOCABILITY, AND GOVERNING LAW

5.1 Creation

Settlor hereby creates this Trust under the laws of the State of Missouri, specifically the Missouri Uniform Trust Code, RSMo §§ 456.1-101 et seq.

5.2 Irrevocability

This Trust is irrevocable. Settlor hereby waives and permanently relinquishes any and all rights or powers, whether alone or in conjunction with others, to alter, amend, revoke, or terminate this Trust, in whole or in part, except as expressly permitted in Article 19. No person or entity, including Settlor, Beneficiary, or any government agency, shall have the power to alter, amend, revoke, or terminate this Trust in a manner that would cause the Trust Estate to be considered an available resource for purposes of determining Beneficiary's eligibility for Government Benefits.

5.3 Governing Law and Situs

(a) This Trust shall be governed by and construed in accordance with the laws of the State of Missouri, including the Missouri Uniform Trust Code (RSMo Chapter 456), without regard to conflict-of-laws principles.

(b) The situs of administration of this Trust shall be in the State of Missouri, County of [________________________________].

(c) The Circuit Court of [________________________________] County, Missouri, Probate Division, shall have primary jurisdiction over matters relating to the construction, validity, and administration of this Trust.

5.4 Severability

If any provision of this Trust Agreement is held to be invalid, illegal, or unenforceable, such provision shall be modified to the minimum extent necessary to make it valid and enforceable, or if modification is not possible, shall be severed, and the remaining provisions shall continue in full force and effect. If any provision is found to jeopardize Beneficiary's eligibility for Government Benefits, that provision shall be deemed void ab initio to the extent necessary to preserve such eligibility.

ARTICLE 6. TRUST ESTATE AND FUNDING

6.1 Initial Trust Property

Settlor hereby transfers and delivers to Trustee the property described in Schedule A attached hereto. Trustee acknowledges receipt of such property and agrees to hold, invest, and distribute the same in accordance with this Agreement.

6.2 Additional Contributions

(a) Third-Party Contributions. Any person other than Beneficiary may add property to this Trust at any time by deed, will, beneficiary designation, or other written instrument, subject to Trustee's written acceptance.

(b) Beneficiary Contributions (First-Party Trust Only). If Option B (First-Party Trust) has been selected in Article 4, assets of Beneficiary may be contributed to this Trust, subject to the requirements of 42 U.S.C. § 1396p(d)(4)(A) and the Medicaid payback provisions of Article 10.

(c) Prohibition on Beneficiary Contributions (Third-Party Trust). If Option A (Third-Party Trust) has been selected in Article 4, under no circumstances shall Beneficiary contribute his or her own assets to this Trust. Any attempted contribution by Beneficiary shall be rejected by Trustee and returned to Beneficiary or, if return would jeopardize Government Benefits, held in a separate first-party trust or deposited into Beneficiary's ABLE Account.

6.3 Separate Accounting

Trustee shall maintain separate accounting for:
- (a) First-party contributions (Beneficiary's own assets), if any;
- (b) Third-party contributions from each contributor, upon written request of the contributor;
- (c) Income and gains attributable to each category of contributions.

6.4 No Minimum Funding

There is no minimum funding requirement for the initial establishment of this Trust.

ARTICLE 7. DISTRIBUTION STANDARDS — SUPPLEMENTAL NEEDS

7.1 Sole and Absolute Discretion

During Beneficiary's lifetime, Trustee shall have sole and absolute discretion to distribute income and/or principal of the Trust Estate for the supplemental needs of Beneficiary. All distributions are subject to the overriding limitation set forth in Section 7.4 and Article 8.

7.2 Authorized Distributions

Trustee may, in Trustee's sole and absolute discretion, make distributions for the following supplemental needs of Beneficiary, which list is illustrative and not exhaustive:

(a) Medical and Health Care:
- Medical, dental, vision, and hearing care not covered by MO HealthNet or other insurance
- Mental health and behavioral health services
- Prescription medications and medical equipment not covered by Government Benefits
- Therapy and rehabilitation services (physical, occupational, speech, music, art)
- Experimental or alternative treatments
- Durable medical equipment, prosthetics, and orthotics

(b) Personal Care and Daily Living:
- Personal care attendants, caregivers, and companion services
- Specialized clothing and personal hygiene items
- Adaptive equipment and assistive technology
- Service animals, their training, veterinary care, and maintenance
- Haircuts, grooming, and personal care services

(c) Housing-Related (Subject to ISM Analysis — See Section 8.2):
- Home modifications and accessibility improvements
- Furnishings, appliances, and household goods
- Maintenance and repair of Beneficiary's residence
- Security systems and monitoring
- Telephone, internet, and communication services

(d) Education and Vocational:
- Tuition, books, and educational supplies
- Tutoring and special education services
- Vocational training and supported employment programs
- Computers, tablets, software, and adaptive technology for education
- Conferences, workshops, and continuing education

(e) Transportation:
- Purchase, lease, and maintenance of a vehicle adapted for Beneficiary's use
- Insurance, fuel, and repair for such vehicle
- Accessible transportation services
- Travel expenses for medical appointments, education, or recreation

(f) Recreation, Socialization, and Quality of Life:
- Vacations and travel (including companion expenses when necessary)
- Entertainment, hobbies, and social activities
- Club memberships, gym memberships, and recreational programs
- Camp programs (including special-needs camps)
- Musical instruments, art supplies, and sports equipment

(g) Professional Services:
- Legal services on behalf of Beneficiary
- Benefits advocacy and case management
- Financial planning and tax preparation
- Guardianship or conservatorship proceedings
- Care management and life planning services

(h) Burial and Final Expenses:
- Prepaid irrevocable burial trust or funeral plan
- Burial plot, headstone, and related items

7.3 Method of Distribution

(a) Wherever practicable, Trustee shall make distributions by paying vendors, service providers, and other third parties directly, rather than distributing cash to Beneficiary.

(b) Trustee may purchase goods and services and allow Beneficiary to use Trust-owned property without such use constituting a distribution of income or resources to Beneficiary, to the extent permitted by applicable law and regulations.

(c) Trustee shall maintain receipts, invoices, and records of all distributions.

7.4 Overriding Limitation — Preservation of Government Benefits

Notwithstanding any other provision of this Agreement, Trustee shall not make any distribution that would result in the reduction, loss, or suspension of any Government Benefits to which Beneficiary is or may become entitled. If Trustee determines that a proposed distribution would adversely affect Beneficiary's eligibility for Government Benefits, Trustee shall either:

• (a) Decline to make the distribution;
• (b) Modify the distribution to preserve benefit eligibility; or
• (c) Defer the distribution until it can be made without adversely affecting benefits.

7.5 No Demand Right

Beneficiary has no right to compel any distribution from this Trust. The Trust is purely discretionary. No person other than Trustee, subject to the provisions of this Agreement, may direct distributions from the Trust.

ARTICLE 8. PROHIBITED DISTRIBUTIONS AND BENEFIT PRESERVATION

8.1 Prohibited Distributions

Except as permitted under Section 8.2, Trustee shall not make distributions from the Trust Estate for:

(a) Cash or cash-equivalent payments directly to Beneficiary;

(b) Food, including groceries, meals, and nutritional supplements, to the extent such distribution would constitute ISM under SSI regulations;

(c) Shelter, including rent, mortgage payments, real property taxes, homeowner's insurance, heating fuel, gas, electricity, water, sewer, and garbage removal, to the extent such distribution would constitute ISM under SSI regulations;

(d) Any item or service that is currently being provided by Government Benefits;

(e) Any item or service that would be counted as income or resources to Beneficiary for purposes of determining Government Benefits eligibility.

8.2 Exception — Intentional ISM Distributions

Trustee may, after consulting with a qualified special needs planning attorney or benefits specialist, make distributions for food or shelter (In-Kind Support and Maintenance) if Trustee determines in writing that:

(a) The benefit to Beneficiary from the distribution outweighs the reduction in SSI benefits (currently limited to a maximum reduction of one-third of the Federal Benefit Rate plus $20 under the Presumed Maximum Value (PMV) rule per 20 C.F.R. § 416.1140);

(b) The distribution is in Beneficiary's best interests;

(c) The distribution does not cause Beneficiary to lose Medicaid/MO HealthNet eligibility; and

(d) The Trustee has documented the analysis and determination in the Trust records.

8.3 Coordination with Government Benefits

(a) Trustee shall monitor Beneficiary's eligibility for all Government Benefits and shall cooperate with applicable government agencies, including the Social Security Administration and the Missouri Department of Social Services, Family Support Division.

(b) Trustee shall provide such information and accountings to government agencies as required by law or regulation.

(c) Trustee shall promptly notify Beneficiary's legal representative and, if applicable, the Trust Protector, of any change in law, regulation, or policy that may affect Beneficiary's Government Benefits or Trust administration.

ARTICLE 9. SPENDTHRIFT PROVISIONS

9.1 Spendthrift Clause

To the maximum extent permitted by Missouri law, including RSMo § 456.5-502 and RSMo § 456.5-503, the interest of Beneficiary in the income and principal of the Trust Estate shall not be subject to:

• (a) Voluntary or involuntary transfer, assignment, pledge, hypothecation, or encumbrance by Beneficiary;
• (b) Attachment, garnishment, execution, levy, or other legal process by any creditor of Beneficiary;
• (c) The claims of any government agency (except as required by 42 U.S.C. § 1396p(d)(4)(A) for first-party trusts upon Beneficiary's death); or
• (d) Any other claim or process whatsoever.

9.2 Beneficiary's Inability to Alienate

Beneficiary shall have no power to anticipate, assign, sell, transfer, pledge, or encumber Beneficiary's interest in the Trust, nor shall Beneficiary have any power to direct distributions from the Trust.

9.3 Protection from Creditors

No creditor of Beneficiary shall have any right or power to reach, attach, or otherwise obtain any interest in the Trust Estate or any distribution from the Trust prior to actual receipt by or on behalf of Beneficiary. Any distribution made by Trustee to a third-party vendor or service provider on behalf of Beneficiary shall not be considered received by Beneficiary for purposes of this Section.

ARTICLE 10. MEDICAID PAYBACK PROVISION (FIRST-PARTY TRUST ONLY)

DRAFTING NOTE: This Article applies ONLY if Option B (First-Party Trust) was selected in Article 4. If Option A (Third-Party Trust) was selected, this entire Article does NOT apply and the Trust Estate shall pass to the Remainder Beneficiaries free and clear of any Medicaid lien or payback obligation.

10.1 Applicability

This Article 10 applies if and only if this Trust is a First-Party Trust established under 42 U.S.C. § 1396p(d)(4)(A). If this is a Third-Party Trust, this Article 10 is void and of no force or effect.

10.2 Medicaid Payback Upon Beneficiary's Death

Upon the death of Beneficiary, and before any distribution to Remainder Beneficiaries, the Trustee shall first pay to the State of Missouri (through the MO HealthNet Division or its successor) an amount equal to the total medical assistance paid on behalf of Beneficiary under the Missouri Medicaid/MO HealthNet program, as required by 42 U.S.C. § 1396p(d)(4)(A). This payback obligation:

(a) Applies only to amounts attributable to Beneficiary's own assets (first-party funds) held in the Trust;

(b) Does not apply to any portion of the Trust funded exclusively with third-party contributions, if separately accounted for;

(c) Is limited to medical assistance actually paid by the State of Missouri during the period that the Trust was in existence (not retroactive to a period before Trust creation);

(d) Shall be satisfied from the Trust Estate only after payment of:
1. Taxes due from the Trust to the State of Missouri and the Internal Revenue Service;
2. Reasonable fees and expenses of Trust administration, including final Trustee fees and legal/accounting expenses;
3. Costs of Beneficiary's last illness, funeral, and burial (to the extent not otherwise paid); and

(e) After satisfaction of the Medicaid payback, any remaining Trust assets shall be distributed to the Remainder Beneficiaries designated in Article 17.

10.3 Claims Process

Trustee shall notify the Missouri MO HealthNet Division (or its successor agency) of Beneficiary's death within sixty (60) days and shall request a statement of the amount of medical assistance paid on Beneficiary's behalf. Trustee shall allow a reasonable period (not less than one hundred twenty (120) days) for the state to submit its claim before making final distributions to Remainder Beneficiaries.

10.4 Multiple State Claims

If Beneficiary received Medicaid benefits from any state other than Missouri, Trustee shall also notify such state(s) and shall satisfy their payback claims on a pro rata basis from the first-party portion of the Trust Estate, as required by applicable law.

ARTICLE 11. ABLE ACCOUNT COORDINATION

11.1 ABLE Account Authorization

Trustee is authorized, but not required, to establish, fund, and manage an ABLE Account for Beneficiary under 26 U.S.C. § 529A and the Missouri ABLE program (MO ABLE), or any other state's ABLE program, if Trustee determines that such action would benefit Beneficiary.

11.2 Contributions to ABLE Account

Trustee may transfer funds from the Trust Estate to Beneficiary's ABLE Account, subject to the following limitations:

(a) Annual contributions shall not exceed the annual ABLE contribution limit (subject to annual adjustment; verify current limit at ablenrc.org);

(b) Trustee shall consider whether ABLE Account contributions would reduce the Medicaid payback obligation (for first-party trusts) or otherwise benefit Beneficiary;

(c) Trustee shall consider the ABLE Account balance limit ($100,000 for SSI resource exclusion purposes) when making contributions;

(d) Trustee shall coordinate Trust distributions with ABLE Account distributions to maximize Beneficiary's supplemental needs coverage.

11.3 ABLE Account as Alternative

If Beneficiary's supplemental needs can be met more effectively through an ABLE Account (for example, for smaller purchases or direct cash needs), Trustee may use the ABLE Account as the primary vehicle for routine supplemental distributions, while retaining the Trust Estate for larger expenditures and long-term asset preservation.

11.4 Rollover from 529 Plan

If Beneficiary is named as the beneficiary of a 529 college savings plan, Trustee may coordinate with the 529 plan custodian to effectuate a rollover to Beneficiary's ABLE Account, subject to applicable annual contribution limits and lifetime rollover caps under 26 U.S.C. § 529A.

ARTICLE 12. TRUSTEE POWERS

12.1 Fiduciary Standard

Trustee shall administer this Trust with the care, skill, prudence, and diligence that a prudent person familiar with special needs trusts and government benefits programs would exercise in a like capacity and situation, in accordance with the Missouri Uniform Trust Code and RSMo § 456.8-804 (Prudent Administration).

12.2 General Powers

Subject to the overriding limitation in Section 7.4 and the restrictions in Article 8, Trustee shall have the following powers, in addition to all powers granted by the Missouri Uniform Trust Code:

(a) Investment Powers:
- Invest and reinvest the Trust Estate in any type of property, including stocks, bonds, mutual funds, ETFs, real estate, money market accounts, certificates of deposit, and alternative investments
- Retain any property received as part of the Trust Estate without liability for depreciation or loss
- Diversify investments as Trustee deems prudent under RSMo § 456.9-901 (Missouri Prudent Investor Rule)

(b) Real Property Powers:
- Purchase, sell, lease, exchange, mortgage, or otherwise deal in real property
- Maintain, improve, insure, and manage real property held in the Trust
- Purchase or maintain a residence for Beneficiary's use (subject to ISM analysis)

(c) Financial Powers:
- Open and maintain bank accounts, brokerage accounts, and safe deposit boxes
- Borrow funds and encumber Trust assets (limited to Trust assets; no personal liability)
- Lend funds from the Trust Estate on commercially reasonable terms (not to Beneficiary)
- Collect and receipt for all income, debts, and claims due to the Trust

(d) Legal Powers:
- Compromise, settle, arbitrate, or litigate claims by or against the Trust
- Participate in any legal proceedings affecting Beneficiary's interests
- Execute all documents reasonably necessary for Trust administration
- Prosecute or defend actions to protect Beneficiary's Government Benefits eligibility

(e) Administrative Powers:
- Employ attorneys, accountants, investment advisors, care managers, benefits specialists, and other professionals, and pay their reasonable fees from the Trust Estate
- Delegate investment and administrative functions pursuant to RSMo § 456.8-807
- Combine Trust assets with other trusts for investment purposes (but maintain separate accounting)
- Make elections and allocations for tax purposes
- Establish sub-trusts if necessary or advisable for tax or benefits planning purposes

(f) Insurance Powers:
- Purchase, maintain, surrender, or convert life insurance, health insurance, disability insurance, or long-term care insurance policies on any person's life
- Pay premiums from the Trust Estate
- Exercise all rights of ownership in insurance policies held by the Trust

(g) Tax Powers:
- File tax returns and make tax elections on behalf of the Trust
- Make distributions to satisfy tax obligations of the Trust
- Elect grantor trust or non-grantor trust status as appropriate (see Article 18)
- Make Section 643(e) elections regarding in-kind distributions

12.3 Duty to Monitor Government Benefits

Trustee shall make reasonable efforts to remain informed of all eligibility requirements, income and resource limits, and policy changes affecting Beneficiary's Government Benefits, including but not limited to:

• SSI resource and income limits
• MO HealthNet eligibility requirements
• ISM rules and calculations
• POMS updates affecting special needs trusts
• Changes to Missouri or federal law affecting the Trust

12.4 Bond

☐ Trustee shall be exempt from any requirement to post bond.

☐ Trustee shall post a fiduciary bond in the amount of $[________________________________], premium payable from the Trust Estate.

12.5 No Self-Dealing

Trustee shall not engage in self-dealing or transactions that create a conflict of interest with Beneficiary, except for payment of reasonable compensation and reimbursement as provided in Article 15.

ARTICLE 13. TRUST PROTECTOR / ADVISORY COMMITTEE

13.1 Appointment of Trust Protector

Settlor hereby appoints the following individual or entity as Trust Protector:

13.2 Powers of Trust Protector

The Trust Protector shall have the following powers, exercisable in a non-fiduciary capacity unless otherwise required by law:

(a) Remove and replace Trustee, with or without cause;

(b) Approve or veto extraordinary distributions exceeding $[________________________________] in a single transaction or $[________________________________] in any calendar year;

(c) Modify the Trust to the extent necessary to comply with changes in federal or state law affecting Government Benefits or tax treatment, provided that no modification shall alter the basic purpose of the Trust as a supplemental needs trust;

(d) Add or remove Remainder Beneficiaries (but not add Beneficiary as a Remainder Beneficiary);

(e) Change the situs and governing law of the Trust if advisable to preserve Government Benefits or improve Trust administration;

(f) Direct the Trustee regarding the hiring or termination of professional advisors;

(g) Approve or reject Trust accountings.

13.3 Successor Trust Protector

If the Trust Protector is unable or unwilling to serve, the following person shall serve as successor Trust Protector:

Name: [________________________________]
Address: [________________________________]

If no successor Trust Protector is willing or able to serve, the Probate Division of the Circuit Court of [________________________________] County, Missouri, may appoint a successor upon petition by any interested party.

13.4 Advisory Committee (Optional)

☐ An Advisory Committee is established consisting of the following persons who shall advise Trustee on Beneficiary's supplemental needs, quality of life, and care planning (advisory capacity only; non-binding):

☐ No Advisory Committee is established.

ARTICLE 14. ACCOUNTINGS, REPORTS, AND INFORMATIONAL RIGHTS

14.1 Annual Accounting

Trustee shall prepare and deliver a written annual accounting to the following persons within ninety (90) days after the close of each calendar year:

• (a) Beneficiary's legal representative (parent, guardian, or conservator)
• (b) Trust Protector
• (c) Any court exercising jurisdiction over the Trust, if required
• (d) Any government agency, upon proper request, to the extent required by law

14.2 Content of Accounting

Each annual accounting shall include, at a minimum:

• (a) Opening balance of the Trust Estate
• (b) All receipts and additions, itemized by source
• (c) All disbursements, itemized by payee, amount, date, and purpose
• (d) All gains and losses on investments
• (e) Trustee compensation and expenses
• (f) Closing balance of the Trust Estate
• (g) A list of all Trust assets and their fair market values
• (h) A summary of Beneficiary's Government Benefits status

14.3 Distribution Records

Trustee shall maintain detailed records of all distributions, including:

• (a) The date, amount, and purpose of each distribution
• (b) The vendor or payee
• (c) Receipts, invoices, or other supporting documentation
• (d) An explanation of how each distribution qualifies as a supplemental need

14.4 Inspection Rights

Beneficiary's legal representative and Trust Protector shall have the right, upon reasonable written request, to inspect Trust records during normal business hours, in accordance with RSMo § 456.8-813.

14.5 Government Agency Reporting

Trustee shall comply with all reporting requirements imposed by the Social Security Administration, the Missouri Department of Social Services, and any other government agency with respect to the Trust.

ARTICLE 15. TRUSTEE COMPENSATION AND REIMBURSEMENT

15.1 Compensation

Trustee shall be entitled to reasonable compensation for services rendered, as follows:

☐ Missouri statutory rate: Reasonable compensation as determined under Missouri law (RSMo § 456.7-708).

☐ Published fee schedule: In accordance with Trustee's published fee schedule in effect at the time services are rendered, a copy of which is attached as Schedule C.

☐ Flat annual fee: $[________________________________] per year, payable quarterly from the Trust Estate, subject to adjustment every [____] years by the Trust Protector.

☐ Percentage fee: [____]% of the fair market value of Trust assets, calculated and payable [annually/quarterly].

15.2 Reimbursement of Expenses

Trustee shall be reimbursed from the Trust Estate for all reasonable out-of-pocket expenses incurred in the administration of the Trust, including professional fees, travel expenses, court costs, and filing fees.

15.3 Court Review

Any interested party may petition the Probate Court for review of the reasonableness of Trustee compensation and expenses.

ARTICLE 16. SUCCESSOR TRUSTEE PROVISIONS

16.1 Designated Successor Trustees

If the initial Trustee ceases to serve for any reason, the following persons or entities shall serve as successor Trustee, in the order listed:

16.2 Resignation

Trustee may resign by giving at least sixty (60) days' written notice to:
- (a) Settlor, if living;
- (b) Beneficiary's legal representative;
- (c) Trust Protector; and
- (d) The Probate Division of the Circuit Court having jurisdiction.

Resignation shall not be effective until a successor Trustee has been appointed and has accepted the trust.

16.3 Removal

Trustee may be removed:

(a) By the Trust Protector, with or without cause, upon thirty (30) days' written notice;

(b) By Settlor (if living) for cause, upon thirty (30) days' written notice;

(c) By the Probate Court upon petition by any interested party for cause, including but not limited to breach of fiduciary duty, gross negligence, incapacity, insolvency, or persistent failure to act;

(d) By the Probate Court if a material conflict of interest exists between Trustee and Beneficiary.

16.4 Appointment of Successor

If no designated successor Trustee is willing or able to serve:

(a) Trust Protector may appoint a successor Trustee;

(b) If Trust Protector fails to act within thirty (30) days, Settlor (if living) may appoint a successor;

(c) If no appointment is made within sixty (60) days, any interested party may petition the Probate Court to appoint a successor, and the Court shall give preference to corporate trustees with experience in special needs trust administration.

16.5 Acceptance and Transition

(a) A successor Trustee shall accept the trust by written instrument delivered to the outgoing Trustee and all notice parties.

(b) The outgoing Trustee shall deliver all Trust property, records, and accountings to the successor Trustee within thirty (30) days of the effective date of succession.

(c) A successor Trustee shall have all the rights, powers, and duties of the original Trustee under this Agreement.

ARTICLE 17. TRUST TERMINATION AND REMAINDER BENEFICIARIES

17.1 Termination Events

This Trust shall terminate upon the first to occur of the following:

(a) Death of Beneficiary;

(b) A determination by Trustee and Trust Protector (or by court order) that the Trust Estate has been reduced to a value ($[________________________________] or less) that makes continued administration impracticable;

(c) A determination that Beneficiary no longer has a disability and no longer receives or is eligible for Government Benefits, and the Trust purpose can no longer be served; or

(d) Such other event as a court of competent jurisdiction may determine warrants termination.

17.2 Distribution Upon Beneficiary's Death

Upon Beneficiary's death, the Trust Estate shall be distributed in the following order:

Step 1 — Final Expenses:
Payment of Beneficiary's debts, last illness expenses, funeral and burial costs, and Trust administration expenses (including final Trustee fees, accountant fees, and attorney fees).

Step 2 — Tax Obligations:
Payment of all taxes due from the Trust to the Internal Revenue Service and the State of Missouri.

Step 3 — Medicaid Payback (First-Party Trust Only):
If this is a First-Party Trust (Option B in Article 4), payment to the State of Missouri (and any other state that provided Medicaid benefits to Beneficiary) of the total medical assistance paid on Beneficiary's behalf, pursuant to 42 U.S.C. § 1396p(d)(4)(A) and Article 10 of this Agreement.

Step 4 — Remainder Distribution:
After satisfaction of Steps 1 through 3, the remaining Trust Estate shall be distributed to the following Remainder Beneficiaries:

17.3 Distribution Upon Termination for Other Reasons

If the Trust terminates under Section 17.1(b), (c), or (d), the Trust Estate shall be distributed:

(a) If Beneficiary is still alive and receiving Government Benefits, by transfer to a new special needs trust, pooled trust under 42 U.S.C. § 1396p(d)(4)(C), or ABLE Account for Beneficiary's benefit, to the extent feasible;

(b) If Beneficiary is still alive and no longer receiving Government Benefits, directly to Beneficiary; or

(c) If Beneficiary is deceased, in accordance with Section 17.2.

17.4 Anti-Lapse

If any Remainder Beneficiary predeceases Beneficiary without leaving surviving issue, such Remainder Beneficiary's share shall be distributed to the surviving Remainder Beneficiaries in proportion to their respective shares. If no Remainder Beneficiary survives Beneficiary, the Trust Estate shall be distributed to Settlor's heirs at law as determined under Missouri intestacy law (RSMo Chapter 474).

ARTICLE 18. TAX PROVISIONS

18.1 Tax Identification Number

The Trust shall obtain its own federal Employer Identification Number (EIN) and file tax returns as required by the Internal Revenue Code.

18.2 Grantor Trust Status (Third-Party Trust)

If this is a Third-Party Trust, Settlor intends that:

☐ The Trust shall be treated as a grantor trust for federal income tax purposes during Settlor's lifetime, with all income, deductions, and credits reported on Settlor's individual income tax return.

☐ The Trust shall be treated as a separate taxable entity (non-grantor trust), filing its own Form 1041 and paying income taxes from the Trust Estate.

18.3 Grantor Trust Status (First-Party Trust)

If this is a First-Party Trust, the Trust shall generally be treated as a grantor trust for federal income tax purposes with respect to Beneficiary, with all income, deductions, and credits reported on Beneficiary's individual income tax return.

18.4 Tax Elections

Trustee is authorized to make all tax elections that Trustee deems appropriate, including but not limited to:

• (a) Selection of the Trust's fiscal year
• (b) Elections regarding capital gains and losses
• (c) Elections under Section 643(e) of the Internal Revenue Code regarding in-kind distributions
• (d) Elections regarding depreciation and amortization methods
• (e) Filing of estimated tax payments

18.5 Generation-Skipping Transfer Tax

If applicable, Settlor or Settlor's estate shall allocate generation-skipping transfer tax (GST) exemption to transfers to this Trust, to the extent Settlor's GST exemption is available. Trustee shall cooperate with Settlor's tax advisors in connection with such allocation.

18.6 Missouri Income Tax

The Trust shall comply with all Missouri income tax requirements, including filing Missouri Form MO-1041 (Fiduciary Income Tax Return) as required.

ARTICLE 19. AMENDMENT AND JUDICIAL MODIFICATION

19.1 Limited Power of Amendment

This Trust may be amended or modified only in the following circumstances:

(a) Legislative or Regulatory Changes: If changes in federal or state law, regulations, or administrative policy make amendment necessary or advisable to preserve Beneficiary's eligibility for Government Benefits or to comply with the requirements of 42 U.S.C. § 1396p(d)(4)(A) (for first-party trusts), Trust Protector may direct Trustee to execute an amendment, provided that no amendment shall alter the basic supplemental needs purpose of the Trust.

(b) Judicial Modification: Any interested party may petition the Probate Court having jurisdiction for modification of this Trust pursuant to RSMo § 456.4-411 (Modification by court — unanticipated circumstances), RSMo § 456.4-412 (Modification by court — purposes of settlor and interest of beneficiaries), or RSMo § 456.4-416 (Modification to achieve settlor's tax objectives), as applicable.

(c) Trustee Petition: Trustee may petition the Probate Court for instruction or modification if Trustee in good faith believes that a provision of this Agreement is unclear, impracticable, or contrary to Beneficiary's best interests or Government Benefits eligibility.

19.2 Restrictions on Amendment

No amendment shall:
- (a) Permit Beneficiary to compel distributions;
- (b) Convert this Trust from irrevocable to revocable;
- (c) Eliminate the Medicaid payback provision (for first-party trusts);
- (d) Alter the Trust in a manner that would cause the Trust Estate to be an available resource for Government Benefits eligibility purposes; or
- (e) Benefit Settlor or any person other than Beneficiary during Beneficiary's lifetime (except for reasonable Trustee compensation and administration expenses).

ARTICLE 20. GENERAL PROVISIONS

20.1 Entire Agreement

This Trust Agreement, together with the attached Schedules, constitutes the entire agreement among the parties with respect to the subject matter hereof and supersedes all prior discussions, negotiations, and agreements.

20.2 Notices

All notices required or permitted under this Agreement shall be in writing and shall be deemed delivered when:
- (a) Personally delivered;
- (b) Sent by certified mail, return receipt requested, to the addresses set forth herein; or
- (c) Sent by nationally recognized overnight courier.

20.3 Counterparts

This Agreement may be executed in any number of counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument.

20.4 Electronic Signatures

Electronic signatures shall be valid and enforceable to the extent permitted by the Missouri Uniform Electronic Transactions Act (RSMo §§ 432.200 to 432.295).

20.5 Headings

Section headings are for convenience only and shall not affect the interpretation of this Agreement.

20.6 No Assignment

Except as expressly provided herein, no party may assign any rights or obligations under this Agreement without the prior written consent of all other parties.

20.7 Interpretation

(a) This Agreement shall be liberally construed to carry out the Settlor's intent as expressed in Article 2.

(b) In the event of any conflict between the provisions of this Agreement and any federal or state law, regulation, or policy governing Government Benefits, the provision that preserves Beneficiary's eligibility for Government Benefits shall control.

(c) If any provision of this Agreement is susceptible to more than one interpretation, it shall be interpreted in the manner that best preserves Beneficiary's eligibility for Government Benefits.

20.8 Applicable Law References

All references to statutes, regulations, and POMS provisions in this Agreement shall be deemed to refer to such provisions as amended, renumbered, or superseded from time to time.

ARTICLE 21. EXECUTION

IN WITNESS WHEREOF, the undersigned parties have executed this Missouri Special Needs Trust Agreement as of the Effective Date set forth above.

21.1 Settlor

Signature: _______________________________________________

Printed Name: [________________________________]

Date: [__/__/____]

21.2 Trustee

Signature: _______________________________________________

Printed Name: [________________________________]

Title (if corporate): [________________________________]

Date: [__/__/____]

TRUSTEE ACCEPTANCE: By executing this Agreement, Trustee accepts the trust created herein and agrees to administer it in accordance with its terms, the Missouri Uniform Trust Code, and all applicable law.

21.3 Trust Protector

Signature: _______________________________________________

Printed Name: [________________________________]

Date: [__/__/____]

21.4 Acknowledgment (Notary Public)

STATE OF MISSOURI
COUNTY OF [________________________________]

On this [____] day of [________________________________], 20[____], before me, the undersigned Notary Public, personally appeared:

• [________________________________] (Settlor), and
• [________________________________] (Trustee),

known to me (or satisfactorily proven through valid government-issued identification) to be the persons whose names are subscribed to the foregoing instrument, and acknowledged that they executed the same for the purposes therein contained.

IN WITNESS WHEREOF, I hereunto set my hand and official seal.

Signature: _______________________________________________

Notary Public, State of Missouri

My Commission Expires: [__/__/____]

Commission Number: [________________________________]

NOTE: Missouri does not require witnesses for the execution of an inter vivos trust. However, notarization provides additional evidentiary protection. If real property is to be transferred to the Trust, a notarized deed of trust is required.

ARTICLE 22. SCHEDULES

SCHEDULE A — INITIAL TRUST PROPERTY

The following property is hereby transferred to the Trustee as the Initial Trust Property of this Trust:

Total Estimated Value of Initial Trust Property: $[________________________________]

Settlor Initials: [____] Trustee Initials: [____] Date: [__/__/____]

SCHEDULE B — APPROVED SUPPLEMENTAL NEEDS EXPENDITURE CATEGORIES

The following categories of expenditures are pre-approved as supplemental needs distributions. Trustee may make distributions within these categories without further approval from Trust Protector, subject to the annual limits specified. Expenditures exceeding the listed amounts or falling outside these categories require Trust Protector approval (if applicable).

Total Annual Budget (Guideline): $[________________________________]

NOTE: These budget amounts are guidelines only and do not limit Trustee's discretion. Trustee may exceed these amounts when doing so is in Beneficiary's best interests and consistent with the Trust purpose.

SCHEDULE C — TRUSTEE FEE SCHEDULE

(Attach Trustee's published fee schedule if applicable, or describe the agreed-upon fee arrangement.)

[________________________________]

SCHEDULE D — BENEFICIARY INFORMATION AND CARE PLAN

(Optional but recommended. Attach a Letter of Intent or Personal Care Plan describing Beneficiary's daily routine, medical providers, medication schedule, preferences, social contacts, religious practices, and other information useful to Trustee in administering the Trust.)

☐ Letter of Intent / Personal Care Plan is attached.

☐ Letter of Intent / Personal Care Plan to be provided separately.

SOURCES AND REFERENCES

• 42 U.S.C. § 1396p(d)(4)(A) — Federal Medicaid statute authorizing first-party special needs trusts for disabled individuals under age 65, with Medicaid payback requirement. https://www.law.cornell.edu/uscode/text/42/1396p

• 42 U.S.C. § 1396p(d)(4)(C) — Pooled trust exception for disabled individuals of any age, managed by nonprofit associations.

• 26 U.S.C. § 529A — ABLE (Achieving a Better Life Experience) accounts providing tax-advantaged savings for individuals with disabilities. https://www.irs.gov/government-entities/federal-state-local-governments/able-accounts-tax-benefit-for-people-with-disabilities

• RSMo §§ 456.1-101 to 456.11-1106 — Missouri Uniform Trust Code, governing creation, administration, and termination of trusts in Missouri. https://revisor.mo.gov/main/OneChapterRng.aspx?tb1=456.1-101+to+456.11-1106

• RSMo § 456.5-502 — Missouri spendthrift trust provision. https://revisor.mo.gov/main/OneSection.aspx?section=456.5-502

• RSMo § 456.5-505 — Creditor's claims against settlor of irrevocable trust. https://revisor.mo.gov/main/OneSection.aspx?section=456.5-505

• RSMo §§ 402.199–402.208 — Midwest Special Needs Trust Act (Missouri pooled trust). https://www.midwestspecialneedstrust.org/

• RSMo § 475.094 — Conservator's power to create trusts for persons under disability. https://revisor.mo.gov/main/OneSection.aspx?section=475.094

• Missouri DSS Manual § 1025.015.04.01 — MO HealthNet eligibility rules for special needs trusts, supplemental needs trusts, and pooled trusts. https://dssmanuals.mo.gov/december-1973-eligibility-requirements/1025-000-00/1025-015-00/1025-015-04/1025-015-04-01/

• POMS SI 01120.203 — SSA policy on trusts, including special needs trust evaluation criteria. https://secure.ssa.gov/poms.nsf/lnx/0501120203

• 20 C.F.R. § 416.1201 — SSI resource exclusions, including trust-related exclusions.

• 20 C.F.R. § 416.1130 et seq. — SSI rules regarding In-Kind Support and Maintenance (ISM).

• ABLE National Resource Center — Contribution limits and program information. https://www.ablenrc.org/

• MO HealthNet Division — Missouri Department of Social Services, healthcare benefits administration. https://mydss.mo.gov/mhd

This template is provided by ezel.ai for informational purposes only. It does not constitute legal advice. Special needs trusts require individualized drafting by an attorney experienced in elder law, disability law, and government benefits. Federal and state laws change frequently; verify all citations and requirements before use.