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Business Information
Name of Business
*
Tax Status
*
C Corp
S Corp
LLC
Sole Proprietor
Partnership
Financial Professional
Name
*
Company
*
Phone Number
*
Email Address
Date Business Began
Date of Incorporation
Tax Year End
State of Issue
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Approximate Contribution Desired
Approximate Contribution Desired kind
%
$
Percent of pay or dollar amount
Any Current Plan in force?
*
Yes
No
If so, please provide details:
Do the owners have ownership interests in any other firms?
Yes
No
Please indicate ownership interests:
Details and Comments
Please include any additional details or comments here
Census Information
If you have more than 10 employees, please upload an Excel spreadsheet with the following information:
-First Name
-Last Name
-% Stock Owned
-W-2 Compensation
-Schedule C or K-1 Income
-Annual Hours (if part time)
-Date of Employment
-Date of Birth
-Family Member or Owner? (Yes or No)
If you have less than 10 employees, you may use the next section to enter the required information.
Excel Attachment File Upload
Drop a file here or click to upload
Choose File
Maximum file size: 67.11MB
Employees
This section is for if you have less than 10 employees
First Name
Last Name
% Stock Owned
W-2 Compensation
Schedule C or K 1 Income
Annual Hours Worked (if part time)
Date of Employment
Date of Birth
Family Member of Owner?
Yes
No
plus1
Add
minus1
Remove
If you are human, leave this field blank.
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