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Proposal Request Form
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Step
1
of 5
Business Name:
*
Phone:
Email:
*
Authorized Contact Person(s):
*
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Address Information
Address
*
Address Line 1
City
--- Select state ---
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State
Zip Code
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Preferred Method of Communication
Contact Me via:
*
Select an option
Office
Cell Phone
Email
Text
CPA:
Email:
Phone:
Advisor:
Email:
Phone:
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Business Information
Type of Entity:
Select an option
LLC - Sole Proprietor
LLC - Partnership
LLC - S Corp
LLC - C Corp
S Corp
C Corp
Sole Proprietor
Partnership
LLLP
Nature of Business:
Business Commence Date:
Employer Identification #:
Business Code (6-digit NAICS #):
Fiscal Year:
Business taxed on a calendar year?
Select an option
Yes
No
Other
Specify:
Are there any shared, leased, union or 1099 employees?
Select an option
Yes
No
Does this business currently or has it ever sponsored a plan?
Select an option
Yes
No
Other businesses owned by the owner or spouses of this business?
Select an option
Yes
No
Desired Contribution:
Desired Plan Year Start:
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Employees
If you have more than 3 employees to list, fill out an Excel spreadsheet.
Email Excel spreadsheet:
[email protected]
Or, Fax to: 407-875-0189
Employee 1:
Name:
Gender:
Date of Birth:
Date of Hire:
Annual (W‐2) Salary:
Ownership % or Family Relationship:
Job Title (Complete for all):
Annual Hours Worked (If <1,000):
Employee 2:
Name:
Gender:
Date of Birth:
Date of Hire:
Annual (W‐2) Salary:
Ownership % or Family Relationship:
Job Title (Complete for all):
Annual Hours Worked (If <1,000):
Employee 3:
Name:
Gender:
Date of Birth:
Date of Hire:
Annual (W‐2) Salary:
Ownership % or Family Relationship:
Job Title (Complete for all):
Annual Hours Worked (If <1,000):
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