If the person needing long-term care has any business interests, please provide a short description giving the name, location, percentage owned, names, relationship of co-owners, and the form of ownership (i.e., sole proprietorship, closely held corporation, partnership, etc.).
Briefly describe or give the name of the Trust in which the person needing long-term care has an interest, or the person who is the source of the inheritance. Please provide a copy of the instrument which creates the interest, if available. If not, please advise how we may obtain a copy.
If the person needing long-term care has any property interests not described above, please explain the nature of the interests and the estimated value of each.