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Home - New Plan Request

New Plan Request

Today's Date Number of copies Date proposal needed

New Plan Takeover plan

401(k)	Safe Harbor 401(k)	403(b)	Non-Qualified
Profit Sharing	Age Weighted or New Comparability		Money Purchase
Other

Financial Advisor Information
Name:
Rep Number
Advisor-Dealer Name
Street Address
City
State
Zip
Phone
Fax
Email

Takeover Plan Information
Type of existing plan
Current value of plan assets:$
Are any of the assets illiquid?	Yes No
Asset Type(s)	GICs
	Mutual Funds
	Insurance
	Annuities
	Company Stock
	Other
Are loans permitted?	Yes No

Employer Information
Company Name:
Number of Employees
Number of Eligible Employees
Type of Entity
C-corp Partnership S-corp Sole proprietorship Other
Is the company a subsidiary or is there substantial common ownership of another Business?
Yes No
If the employer is a member of a controlled group of corporations it may be required to offer the chosen plan to the employees of the related company of companies.

Proposal Details
Single fund Family	Multiple Fund Family
Investment Provider(s)

Corporate Trust Services:
Yes No

Note:

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