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SPECIAL NEEDS TRUST SURETY BOND APPLICATION
With over 110 years’ worth of underwriting experience and proudly representing over 30 sureties, American Surety Bonds is here to support your bonding needs!
Special Needs Trust Surety Bond Application
darren
2020-06-23T03:45:17-04:00
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AMERICAN SURETY BONDS AGENCY
138 Hammond Drive
Suite B
Atlanta, GA 30328
1.877.201.8976
404.393.0826
info@suretybondsagency.com
Mon – Fri . 8:00 – 6:00
SOCIAL
SURETY BOND APPLICATION
Please select your surety bond from the list of bonds below.
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Step
1
of 6
Select Bond
*
Special Needs Trust
Bond Amount
*
Probate Court (County)
*
Next
Trustee Information
Name
*
First
Last
Email
*
Phone
*
Address
*
Address Line 1
Address Line 2
City
Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
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Iowa
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Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
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Nevada
New Hampshire
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Ohio
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Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
SSN
*
Date of Birth
*
Estimated Net Worth
*
Martial Status
*
Select Status
Single
Married
Divorced
Relationship to Trustee
*
Natural Parent?
*
Select
Yes
No
Do you own a home?
*
Select
Yes
No
Date home was purchased
Original Cost
Current Value
Employer
*
Position
*
How long employed?
*
Spouse's Name
First
Last
Spouse's SSN
Spouse's Date of Birth
Spouse's Employer/Position
Previous
Next
Beneficiary Information
Full Name of Beneficiary
*
First
Middle
Last
Date of Birth
*
SSN
*
With whom does the beneficiary live?
Ward's Attorney
*
First
Last
Firm Name
*
Attorney Phone
*
Previous
Next
Underwriting Information
What is the source of the funds?
*
Where will the funds be kept?
*
Will the funds be used to support the beneficiary?
*
Select
Yes
No
Is there any current litigation?
*
Select
Yes
No
Is this a structured settlement?
*
Select
Yes
No
Previous
Next
List two next of kin to the Trustee
Next of Kin Name
First
Last
Relationship
Phone
Address
Address Line 1
Address Line 2
City
Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Next of Kin Name
First
Last
Replationship
Phone
Address
Address Line 1
Address Line 2
City
Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Next
Contact Information
Attorney Name
*
First
Last
Firm Name
*
Phone
*
Email
*
Address
*
Address Line 1
Address Line 2
City
Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Trustee Phone
*
Trustee Cell Phone
*
Trustee Work Phone
*
Trustee Email
*
File Upload
Supported file types are: .doc .pdf .jpg .jpeg .png
Signature
*
Clear Signature
Date
*
Name
Submit Application
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