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TRUST INTAKE SHEENA: ___DATE:___1. Granter/Settler\'s Information:Full Name:___Street Address:___City:___State:___Zip Code: ___Home Phone: ___Cell Phone: ___Business Phone: ___Email: ___Social Security
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What is POMS: GN 00602.075 - Transfer of Benefits to a Trust Form?

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Information such as financial data, identification details, or any other specified information may need to be reported on POMS GN 00602075.
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