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401(k) Census Proposal Request

Please fill out as much information as possible and we'll get back to you with a quote right away

Employer Information
Company Name:
Email Address:
Contact Name:
Phone Number:
Federal tax status of entity:
Is this a subsidiary of another corporation No Yes Corporation Name
Is this an affiliated service group? No Yes
Estimated number of eligible employees
Do any stockholders of this company have any ownership interest in other companies? No Yes
 If Yes, please detail

Contribution Information
Employer does does not want to have a required contribution annually.
The employer currently has no existing plan
The employer currently has a retirement plan with $ assets
The employer has had a defined benefit plan.
Has employer ever had a prior qualified plan? No Yes
If yes, please explain:

Company Census Information
Last NameFirst NameDate of Birth
(mm/dd/yyyy)		Projected Annual Comp.HCE
y/n		Preferred Participant
y/n

 
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