Special Needs Trust - New York

NEW YORK THIRD-PARTY SUPPLEMENTAL NEEDS TRUST

Trust name: [BENEFICIARY FULL NAME] Supplemental Needs Trust

Date: [__/__/____]

Before signing: Use this form only for a third party's property. Do not place the beneficiary's own property, the beneficiary's spouse's property, or property owed to the beneficiary under a support or other financial obligation in this trust. A first-party trust requires a different instrument and separate benefits review. Describe the property actually transferred in Schedule A. Complete the disability description, successor trustees, and 100% remainder in Schedule B. The settlor and trustee must sign in the presence of two witnesses who sign below, or use an acknowledgment method meeting N.Y. EPTL § 7-1.17.

1. Creation and funding

I, [SETTLOR FULL NAME], of [ADDRESS], create this irrevocable trust by transferring the identifiable property in Schedule A to [TRUSTEE FULL NAME], of [ADDRESS], as trustee. The trustee acknowledges receipt and accepts the trusteeship. New York law governs this trust. Later property effectively transferred by a permissible third party becomes trust property. An anticipated future gift is not treated as already transferred.

The sole current beneficiary is [BENEFICIARY FULL NAME], born [DATE], of [ADDRESS]. The beneficiary has [DESCRIBE MENTAL ILLNESS, DEVELOPMENTAL DISABILITY, OR OTHER PHYSICAL OR MENTAL IMPAIRMENT], which has caused or is expected to cause a long-term need for specialized services, and may require government benefits or assistance, as described in N.Y. EPTL § 7-1.12(a)(4). Keep the supporting determination or professional records with the trust records.

The trustee shall reject property belonging to the beneficiary or the beneficiary's spouse. The trustee shall also reject property supplied to discharge a legal support obligation or another financial obligation to the beneficiary to the extent of that obligation. These funding limits reflect N.Y. EPTL § 7-1.12(a)(5) and (c). This instrument does not claim the first-party trust exception or promise benefits eligibility.

2. Irrevocability and supplemental purpose

This trust is irrevocable. The settlor retains no unilateral power to revoke, amend, or withdraw its property. Its purpose is to supplement, not supplant, impair, or diminish government benefits or assistance for which the beneficiary may otherwise be eligible or which the beneficiary receives.

3. Distributions

The trustee may distribute income or principal, in the trustee's discretion, for the beneficiary's supplemental needs. No payment is mandatory. The trustee should consider available public and private assistance and may consult a qualified benefits adviser before a proposed payment.

Mandatory restriction: The trustee shall not expend or distribute trust assets in any way that may supplant, impair, or diminish government benefits or assistance for which the beneficiary may be eligible or which the beneficiary receives. This instrument grants no exception for a payment that would have that effect. If a proposed payment's benefit effect is uncertain, the trustee shall defer it pending review. The beneficiary has no power to assign, encumber, direct, distribute, or authorize distributions of trust property.

Actual distributions can affect program eligibility or payment amounts. Federal SSI rules now generally count shelter, rather than food itself, as in-kind support and maintenance, but food and household facts can still affect a shelter valuation rule. The trustee shall check the current facts and applicable program rules before paying for food or shelter. The trust does not guarantee any benefit outcome.

4. Administration and successor trustees

The trustee shall keep separate trust records and record each distribution's recipient, amount, purpose, and known benefit effect. The trustee may hold, invest, insure, lease, sell, and manage trust property; pay proper expenses; and employ advisers. The trustee shall use reasonable care, skill, and caution in investment and management under N.Y. EPTL § 11-2.3. Reasonable compensation and proper expenses may be paid from trust property. No clause here excuses breach of fiduciary duty or caps a lawful remedy.

If the initial trustee cannot or will not serve, [FIRST SUCCESSOR FULL NAME AND ADDRESS] shall serve; if unavailable, [SECOND SUCCESSOR FULL NAME AND ADDRESS] shall serve. A successor accepts in a signed writing retained with the trust records. The outgoing trustee shall deliver the property and records to the successor. If no named successor serves, an interested person may seek a trustee appointment from a court with jurisdiction.

5. Death and remainder

The trust terminates at the beneficiary's death. The trustee shall first pay or reserve for proper trust expenses and enforceable obligations, then distribute all remaining property in the Schedule B shares. Each share goes to its named recipient if living at the beneficiary's death, otherwise to its alternate. If neither survives, that share is divided proportionately among the other surviving recipients or alternates. If none survives, the entire remainder goes to [FINAL CONTINGENT RECIPIENT FULL NAME AND ADDRESS]. Schedule B shares must total 100%. The trustee may distribute property in kind at fair values and shall give a final account.

6. Execution before two witnesses

I intend to create this irrevocable third-party supplemental needs trust and transfer the initial property in Schedule A. The settlor and trustee sign this instrument in the presence of the two witnesses below, who affix their signatures to it.

Settlor signature: ______________________________

Printed name: [SETTLOR FULL NAME] Date: [__/__/____]

Trustee signature: ______________________________

Printed name: [TRUSTEE FULL NAME] Date: [__/__/____]

Witness 1 signature: ______________________________

Printed name and address: [FULL NAME AND ADDRESS] Date: [__/__/____]

Witness 2 signature: ______________________________

Printed name and address: [FULL NAME AND ADDRESS] Date: [__/__/____]

Schedule A — property actually transferred

Schedule B — remainder recipients