Family Member Proxy Transfer Request
Submit your request to transfer rights, responsibilities, or assets to a family member via proxy. Please complete all required information to ensure proper processing.
Transferor's Full Name
*
First Name
Last Name
Transferor's Email Address
*
example@example.com
Transferor's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Transferee's Full Name
*
First Name
Last Name
Transferee's Email Address
*
example@example.com
Transferee's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
What is your relationship to the transferee?
*
Please Select
Parent
Child
Sibling
Spouse/Partner
Grandparent
Other
Please describe what is being transferred (e.g., responsibility, right, asset)
*
Reason for the proxy transfer
*
Effective date for the transfer
*
-
Month
-
Day
Year
Date
Upload supporting documents (if any)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Signature of Transferor (required to authorize this request)
*
Submit Request
Submit Request
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