Distribution Request Form

Distribution will be reviewed within 5 business days from receipt.
All distributions must be approved by a CTS trust administrator per the terms of your trust document.
If paying a company, use the Vendor Distribution Request Form. Tax ID is required.
Please provide a copy of the invoice and proof of payment if this distribution is a reimbursement.
If this distribution is to cover a service that was rejected by your local, state, or federal benefit program please provide proof of rejection.

Download Distribution Request Form (PDF)

Email(Required)

Phone(Required)

Name(Required)

First Last

This field is hidden when viewing the form

Trust Account Number

Amount Requested(Required)

Pay Type(Required)

Physical Check

Wire In

True Link

Online Purchase

Other

Payee Name(Required)

Payee Address(Required)

Street Address Address Line 2 City State ZIP Code

Online Account Log In(Required)

Please confirm with your bank regarding the routing number for a "Federal Wire", this may be different than the number listed on your checks. Please note wire transactions cost between $21.00-$25.00 per transaction charged to the trust and your bank may charge fees to receive the funds.

I acknowledge this message.(Required)

YES

Wire In - Bank Name(Required)

Wire In - Account Name(Required)

Wire In - Account #(Required)

Wire In - Wire Routing #(Required)

Reason for Distribution(Required)

Date(Required)

Electronic Signature

File

Max. file size: 50 MB.

File

Max. file size: 50 MB.

File

Max. file size: 50 MB.

Distribution Request Form

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