Special Needs Trust Intake | LAESQUIRE

Special Needs Trust Intake — LAESQUIRECA Bar #249708818-714-1789

🔒 Confidential & Secure. All information is protected by attorney-client privilege. No attorney-client relationship until a fee agreement is signed.

Your Info

Beneficiary

Benefits

Trustee

Funding

Review & Pay

Step 1 of 6

Step 1 — Your Information

Tell us about yourself — the person creating this trust.

A Special Needs Trust is typically set up by a parent, grandparent, or guardian to protect a disabled family member's eligibility for government benefits like SSI and Medicaid while providing extra support. This intake is a placeholder — full details will be collected during your consultation.

⚠️ Important: Special Needs Trust rules are complex. The type of SNT (first-party, third-party, or pooled), the source of funds, and the beneficiary's current benefit status all affect how the trust must be structured. Shekhar will review your specific situation during a consultation before drafting begins.

Your Contact Information

First Name *

Last Name *

Email *

Phone *

Your Relationship to the Beneficiary *

City / Neighborhood

Step 2 — The Beneficiary

Tell us about the person with special needs.

This is the person who will benefit from the trust — your disabled child, sibling, or other family member.

Beneficiary Information

Beneficiary Full Name *

Date of Birth *

Diagnosis / Condition(s) (general — no medical records needed yet)

Current Living Situation

Brief description of needs and daily support required (optional)

Step 3 — Current Government Benefits

What benefits does the beneficiary currently receive?

This is critical — the trust must be structured to protect these benefits, not jeopardize them.

Benefits Information

Current government benefits received (check all that apply)

SSI (Supplemental Security Income) SSDI (Social Security Disability) Medi-Cal / Medicaid Medicare Regional Center services Housing assistance (Section 8) None currently Not sure

What is the source of funds going into this trust? *

Has the beneficiary ever been denied benefits due to excess assets?

Any additional context about benefits or timing concerns (optional)

Step 4 — Trustee Selection

Who will manage the trust?

The trustee must NOT be the beneficiary. They must understand benefit rules, investment duties, and recordkeeping. This is one of the most critical decisions in setting up a Special Needs Trust.

Trustee Information

Primary Trustee Full Name *

Relationship to Beneficiary

Phone

Successor Trustee (backup) Full Name

Relationship to Beneficiary

Are you interested in a professional or corporate co-trustee?

Any concerns about trustee selection you'd like to discuss?

Step 5 — Trust Funding & Wishes

How will the trust be funded and what should it cover?

Funding Sources

How do you plan to fund this trust? (check all that apply)

Through my living trust / estate plan (funded at death) By transferring assets now (funded during lifetime) Life insurance payable to the trust Settlement proceeds / court-ordered (first-party SNT) Gifts from multiple family members over time Not sure yet

Approximate amount to be placed in trust (estimate is fine)

What would you like the trust to cover for the beneficiary?

Any special instructions or concerns to discuss with Shekhar?

Step 6 — Review & Consultation Deposit

Almost there. Let's get you scheduled.

Because Special Needs Trust drafting requires a detailed consultation before documents can be prepared, the deposit here secures your consultation with Shekhar. Pricing for the trust itself will be quoted after the consultation based on your specific situation.

$250

Consultation Deposit — Special Needs Trust

Applied to your trust drafting fee after the consultation. Shekhar will contact you within one business day to schedule.

Note on Pricing: Special Needs Trust complexity varies significantly depending on the type of trust (first-party vs. third-party), funding sources, benefit status, and family dynamics. Pricing is quoted after a consultation. The $250 deposit is credited toward your final fee.

Pay Consultation Deposit

Other payment options:
Zelle: or Zelle to 818-714-1789 · Check: SNC Law Office — Call 818-714-1789 for mailing address
Questions: 818-714-1789

This intake form is a placeholder. Full details will be collected during your consultation with Shekhar Chikhalikar, Esq. Submitting this form does not create an attorney-client relationship. Legal services by SNC Law Office, CA Bar #249708.