Change of Beneficiary Advocate and Successor Advocate Form

Trust Beneficiary Full Name:

Trust Beneficiary Address:

I,

, am the

I understand that this change of Beneficiary Advocate is not effective until accepted by the non-profit/ charity and trustee.

I hereby appoint the person named below as the new Beneficiary Advocate for the above named Trust Beneficiary.

Full Name:

Full Address:

Relationship to Beneficiary:

Email:

Phone:

Alternate Phone:

I hereby appoint/nominate the individual below as Successor Beneficiary Advocate for the above named Trust Beneficiary in the event that

I,

(Current Beneficiary Advocate) am no longer able to fulfill my duties as advocate in the event of my disability or passing.

Full Name:

Successor Advocate Signature

Full Address:

Relationship to Beneficiary:

Email:

Phone:

AlternatePhone:

I wish the Non-Profit/Charity to appoint a Beneficiary Advocate for the above named Trust Beneficiary.

Trust Beneficiary/Advocate Full Name:

Trust Beneficiary/Advocate Signature:

Date:

MM slash DD slash YYYY

NON-PROFIT/CHARITY USE ONLY:

The non-profit/charity hereby accepts this change of Beneficiary Advocate.

Sign:

Date:

MM slash DD slash YYYY

Print:

Title: