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Irrev Qualified Income Trust

Settlor ?
Spouse/DPOA/Guardian/Other Signed ?
Notary Signed ?
Marked with "X" ?

How It Works

There are several ways that the signor can execute a document. Depending on how such a document is executed determines the appropriate notary language for the document.

  1. Sign for Self – The person can sign for his/her self - legibility is not a requirement
  2. Legal Authority Signs for Them (Guardian, DPOA, Other) – Some documents allow for a legal authority to sign and some do not. When available the choice will be presented.
  3. Notary Sign – When a person is physically unable to sign or make a mark, a notary can sign on behalf of the person, as long as, the person can somehow indicate his/her desire for the notary to take such action
  4. Marked with an X – When a person is only physically able to make a mark, typically an X, the notary can notarize the mark

Explanation of parties to the document

  1. Settlor Full Name - Please enter the name of the person whose income will be going into the trust. Type the name as exactly as you would like it to appear on the document - (This is the Medicaid applicant)
  2. Signed by - Select who will be signing the document for the person whose income is going into the trust.
    • Settlor/Medicaid Applicant
    • The person who has legal authority pursuant to a properly drafted and executed Power of Attorney,
    • A court ordered guardian,
    • The spouse of the Medicaid applicant
    • Anyone instructed to create the trust by the Medicaid applicant or the spouse of the Medicaid Applicant
    • The notary, if the person signing is physically unable to make a mark but can direct the notary to sign on his/her behalf
  3. Trustee Full Name - This is the name of the person who will be handling the affairs of the trust for the Settlor / Medicaid applicant and should be entered exactly as it will be printed on the document
  4. Add Successor Trustee - This should be completed if you wish to have a backup trustee to act if the initial trustee is unable or unwilling to act for any reason and should be entered exactly as it will be printed on the document.
  5. Settlor Total Income - This is the GROSS INCOME (The amount of income before deductions such as taxes, union dues, insurance premiums, etc.)
  6. Medicaid Income Cap - The amount of maximum gross income set by the state for Medicaid applicants. In 2020 the number is $2,349 and adjusts annually.
  7. Income Cap Deposit Cushion - This is an additional amount to add to the trust deposit to compensate for forgotten income, forgotten deductions, COLA adjustments or anything else that could cause the needed deposit to be greater than calculated. You can think of this as your error amount if you are wrong about the gross income. Better to much than to little.
  8. Click Create
  9. Now in the top right corner click Create Doc to convert to a Word document. Keep in mind that two documents will be created. The trust and generalized funding instructions. If you cannot find the instructions go to your download folder.
  10. It's that simple!!