Retirement Plan Proposal Request

In order to obtain a quote please fill out the following form and click "SUBMIT" below. We will automatically receive your information and begin working on your quote immediately. If you would like to discuss the quote request with us, please contact our office.

All fields are required unless indicated optional.

 

If more than 5 , how many employees do you want to list?

 

This quote is for:

Traditional 401 (k) Plan Profit Sharing Plan
Money Purchase Pension Plan Defined Benefit Pension Plan (412 i)
Simple 401 (k) Plan Simple IRA Plan SEP/IRA
Company Name:
Contact Name:
Company Address :
City:
State:
Zip:
Email Address:
Your Phone Number:
Extension: (optional)
Fax Number:
What is the nature of your business?:
What is your company's Standard Industrial Classification (SIC) ? (Not required) (optional)
When was this company started? (mm / dd / yyyy)
/ /
Do you currently have a Plan? Yes No

If so please indicate what type of plan, the plan administrator and how current plan assets are managed. Please also give a brief description of the plan(s):

# Employee Initials Gender Employee Zip Code
(if out of area) 		Employee Date of Birth
(mm/dd/yyyy) 		Annual Earnings
(including overtime & bonuses) 		Date of Hire (mm/dd/yyyy)
1.
2.
3.
4.
5.

 
 

 

Close This Window

Copyright © <% =Year(Date()) %> Your Agency Name