Please fill out this form only if you do not have an existing Plan.
About The Company
Name:
Address:
Name of Person Interviewed:
Title:
Who is the ultimate decision makers?
Type of Business:
Corporation Subchapter-S Corporation Partnership Governmental
Non-Profit Other
If Other,please specify:
Years in Business:
Number of Employees:
Are any employees leased? Yes No
Are any employees union members? Yes no
Name of Attorney:
Name of Accountant:
About Your Employees
List any Owner/Employees (5% or greater ownership)
Name
Ownership %
Annual Earnings
1.
2.
3.
4.
Total Number of Full-time (working over 1,000 hours per year),
Non-Union employees:
Total Annual Payroll for Full-time Employees:
Does the company have any union or leased employees? Yes No
If "YES" how many?
Are they covered by any other plan? Yes No
If "Yes", please explain:
About Your Goals
What is your primary goal in setting up a retirement plan?
Maximum benefits for owners and other key employees
Attract and retain employees
Provide an opportunity for employees to save for their own retirement
Minimize corporate expenditures on the plan
How much money ($ amount or percentage of payroll) are you willing to commit to the plan to achieve these goals?
About The Financial Consultant
Investment Consultant Submitting Proposal Request:
Broker Dealer:
Your Email Address