Common use of Secondary Advocate 1 Clause in Contracts

Secondary Advocate 1. Mr. Mrs. Ms. Last 4 Digits of SSN: Address: City: State: Zip: Cell Phone: Home Phone: Email Address: Work Phone: *Relationship to Beneficiary: Permission to receive financial account information? a) Immediately upon funding? ☐ YES ☐ NO b) If requested in the future? ☐ YES ☐ NO If YES to a) or b), indicate financial account access preference: ☐Online ☐Mail *Provide CCT with legal documentation for Guardianship, Power of Attorney, and/or Conservator.

Secondary Advocate 1. Mr. Mrs. Ms. Last 4 Digits of SSN: Address: City: State: Zip: Cell Phone: Home Phone: Email Address: Work Cell Phone: *Relationship to Beneficiary: Permission to receive financial account information? a) Immediately upon funding? ☐ YES ☐ NO b) If requested in the future? ☐ YES ☐ NO If YES to a) or b), indicate financial account access preference: ☐Online / Internet ☐Mail *Provide CCT with legal documentation for Guardianship, Power of Attorney, and/or Conservator.