In order for CPT to consider the purchase of a house using trust assets, you must supply the information requested below.
Percentage of Purchase Price:
Is there any warranty on the property?:
Has the house been inspected?:
How will property be deeded?
Percentage of ownership by beneficiary:
How will the shelter items listed below be paid & estimated monthly amount?
How will other expenses be paid & estimated monthly amount?
Do you plan on making renovations or making large purchases in relation to the property?
If yes, what and what is the estimated amount to be requested from the trust?
For beneficiaries receiving SSI, the purchase of a home and/or payments of a mortgage, real property taxes, rent, heating fuel, gas, electricity, water, sewer, & garbage removal may result in a reduction of benefits.
The beneficiary’s ownership percentage must be equal to the percentage paid by the trust. Some exceptions do apply.
- Appraisal or other documentation as to the value of the home
- Closing statement or similar document
Please note, a final determination cannot be made until all support documentation has been received and reviewed.
Beneficiary Checklist for the Purchase of a Home
Please complete the form by initialing each blank to the left of the request and fill out each blank completely. If a blank is not applicable, write in “N/A”. Requests for purchase of home will not be considered until this form is completed.
Name of Beneficiary Advocate
Name and relationship of person(s) requesting disbursement for home purchase
Acknowledge that Beneficiary has sufficient mental capacity to manage his or her own home
If Beneficiary does not have sufficient mental capacity to manage his or her own home, then acknowledge that his or her legal representative has legal authority to manage Beneficiary’s home.
- Provide copy of Power of Attorney with Real Property Authority
- Provide copy of Letters of Conservatorship of Estate
Summary of Request for Home Purchase
Provide address of proposed home
Current amount of Beneficiary’s Sub-Account is $
a. Requested distribution amount from Sub-Account for purchase of home by Beneficiary is $
b. Percentage of Beneficiary’s Sub-Account requested is
Acknowledge that no more than one-half of Beneficiary’s Sub-Account may be used for home purchase
Acknowledge that in order to obtain disbursement for home request, the home will be owned by Beneficiary as his or her primary residence
Acknowledge that it is solely within the trustee’s discretion to disburse trust funds (or refuse to disburse trust funds) so Beneficiary can purchase the home in his or her own name even when no more than one-half of Beneficiary’s Sub-Account is used
Acknowledge that in the month of the purchase of the home, the beneficiary, if an SSI recipient, will trigger SSA income called In-Kind Support and Maintenance (ISM) that may reduce the SSI check
Acknowledge that the Beneficiary or his or her Representative Payee must provide notice to the Social Security Administration and Department of Health Care Services as required
Provide the name and phone number of the real estate broker who is assisting you and the name and phone number of the real estate broker assisting the seller
b. Phone number of your broker
c. Name of seller’s broker
d. Phone number of seller’s broker
Acknowledge that the Beneficiary or Beneficiary Advocate has personally inspected home for suitability for Beneficiary
Schedule a home appraisal or provide comparable sales near home
Send a copy of the home appraisal to CPT once completed or comparable home sale information
Provide the home inspection report to Trustee
Acknowledge that if the Beneficiary owns the home in his or her own name, the Department of Health Care Services has a right to recover against the Beneficiary’s “estate” for all Medi-Cal services provided to beneficiary after they die. The situation may not arise if the Beneficiary owns the home in a living trust, so the Beneficiary is encouraged to seek an attorney knowledgeable in this area to provide advice on the best way to manage the home transfer after the death of the Beneficiary
Home Expenses and Sustainability
State estimated annual cost of property tax for home $
Obtain homeowners insurance for home
a. Provide annual cost of home insurance $
b. Name of insurance broker
c. Name of home insurance company
List estimated cost to Beneficiary:
b. Accessibility modifications or repairs to home $
Acknowledge that CPT and the Beneficiary or Beneficiary Advocate must agree on which party is responsible for paying foregoing expenses and the Trustee is under no obligation to pay for any such items
Others Living in Home
List names and relationship of all persons expected to live in home:
e. Add additional sheet if necessary
Describe how much these people will pay on a monthly basis to assist with home expenses:
Acknowledge that if other persons living in the home pay rent while the home is owned by the Beneficiary, that if the Beneficiary is an SSI recipient, rent payments will cause a dollar-for-dollar reduction of his or her SSI check (after the first $20) as unearned income. For example, if the Beneficiary charges rent of $500 a month, it will reduce the SSI check by $480 a month.
Acknowledge that if the Beneficiary does not pay for his or her fair market share of utilities and the Beneficiary is an SSI recipient it will cause a reduction of the SSI check based off of In- Kind Support and Maintenance (ISM) income
I declare under penalty of perjury that the information provided in this form/packet is true and correct.