Patricia E. Kefalas Dudek
Advocate for Elders, People
with Disabilities
and Their Families
Client intake forms used in order to gather relevant information and best serve our clients' needs.
Legal Links
(Related to my
practice areas)




Client Intake and Info Forms

Client Information / Intake Form (estate planning matters)

Client Information / Intake Form (non estate planning matters)

Client Information / Intake Form (OBRA 1993 for clients)

Client Information / Intake Form (OBRA 1993 for lawyers)

Letter of Intent Information (re: child)

Notice of Fees (estate planning matters)

Notice of Fees (non estate planning matters)

Policy on Review of Another Firm's Work

Possible Use of Charitable Remainder Trust (letter)

Retainer Agreement (estate planning)

Retainer Agreement (hourly work)

Retainer Agreement (Exception A Trust)

Retainer Agreement (Exception C Trust)

Pooled Account Trusts

Notice of Fees (pooled account holders)

Pooled Account Trust Benefits Checklist

Pooled Account Trust List of Permissible Distributions

Disclosure and Consent to Investment Advisory Mix

Form ADV - Diversified Portfolios (info on investment advisor)

Info to be provided to incoming pooled trust beneficiaries:

Standardized Performance Data and Disclosures (as of 3/21/09)

Best/Worst Returns
Comparisons of the S&P 500 Index, Five Year US Treasury Notes, CRSP Deciles 9-10 Index and 60/40 Mix

Performance
Info on the performance of the S&P 500 Index, Five Year US Treasury Notes, CRSP Deciles 9-10 Index and 60/40 Mix

Portfolio Holdings (as of 3/31/2009)
Friends of CLS Trust info and values

Performance Comparisons
Compares Friends of CLS Pooled Trust to 7 common benchmarks

Springhill Pooled Trust Performance Reports (1/1926 - 12/2009)
Includes Best/Worst Return, Distribution of Returns, Disclosures and Performance Comparisons.

Special Needs Trusts

Benefits Checklist - For administering a special needs trust - used to determine if the beneficiary is getting all the public benefits they can.

Duties and Responsibilities of the Trustee of a Special Needs Trust

Joinder Agreements

Friends Joinder

Springhill Housing Joinder Agreement

Springhill Housing Joinder Agreement (with 10% provision)

Springhill Housing Joinder Agreement (with JARC provision)

Springhill Housing Joinder Agreement (with 10% and JARC provision)

Medicaid Related
Medicaid Checklist of Documents (material needed for claims, etc.)
Miscellaneous Forms

Expense Report (sample)

Freedom of Information Act request letter

Health Care Values History Form (updated)

Personal Care Contract

Personal Service Contract

Social Security Related

Appointment of Representative (SSA form) - Those that want to help a family member apply for benefits should have the family member sign this.

Documents Required When Filing for SSI and/or SSDI

Personal Links
(Get to know me outside the office)


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