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Special Disbursement Not in Case Assessment Form 2012 - proxyparentfoundation

Special Disbursement Not in Case Assessment Form 2012 - proxyparentfoundation-2025

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The document is a Special Disbursement Request form for the PLAN of California Master Pooled Trust, designed for beneficiaries to request funds for expenditures not included in their case assessment. It outlines the necessary information required for submission, including beneficiary details, financial purpose, and payment instructions. The form emphasizes that disbursements must benefit the beneficiary without jeopardizing their government benefits, particularly regarding food or shelter expenses. Approval from a primary representative or authorized third party is required before processing any requests.

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