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I have read and understand the need to prepay for the Beneficiary s funeral expenses especially if the Beneficiary has received Medicaid assistance at any time. I understand that I must submit an irrevocable burial plan or contract and a Disbursement Request Form to the Master Pooled Trust for payment PRIOR to the passing of the Beneficiary. TO SUBMIT THIS FORM E-Mail Trust thearcoftexas. org FAX 512-454-4956 MAIL 8001 Centre Park Drive Suite 100 Austin Texas 78754 ACKNOWLEDGEMENT OF POLICIES...

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