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Employer's Company Information

Legal Company Name

DBA

Company Phone

Website

Entity Type

Federal Tax ID (EIN)

Fiscal Month End

Address Line 1

Address Line 2

City

State

Zip/Postal Code

Country

Mailing address same as physical address?

YesNo

Mailing Address

Address Line 1

Address Line 2

City

State

Zip/Postal Code

Country

Employer's Plan Information

Does your company currently offer a 401(k) plan?

YesNo

Number of employees receiving a W-2

Legal name of 401(k) plan

The legal plan name can be found in the legal documents or latest Form 5500 filing.

Number of participants with a balance in the 401(k) plan

Financial Professional Information

Are you working with a financial professional?

YesNoPlease select "Yes" if your company is working with a financial adviser or 401(k) advisor. By providing their contact information, we will include them on all correspondence related to the implementation of our services.

Company Name

First Name

Last Name

Title

Phone

Employer's Primary Contact Information