QUALIFIED PLAN FACT FINDER st.com
|[pic] |
|Qualified Plan Fact Finder |
|Employer (Company) |
|Company Name: |
|Type of Business: |
|Type of Entity: |( C-Corp |( S-Corp |( Partnership |( 501(c)(3) |( Public School |
|( Tax-exempt Organization |( State/Local Government |( Other |
|Address: |
|City: |State: |ZIP Code: |
|Phone Number: |Fax Number: |
|Contact Person: Title: |
|Email: |Tax Year End: / / (Month/Day/Year) |
|Do the owners have ownership in any other business: ( Yes (explain) ( No |
|Provider Information |
|Advisor's Name: |Advisor's Company: |
|Current Service Provider |( Bundled |( Outside TPA |
|TPA Name: |
|THE CURRENT PLAN |
|( New Plan ( Existing Plan |
|Plan Type(s): ( Traditional 401(k) ( Safe Harbor 401(k) ( 403(b) ( Profit Sharing |
|( Money Purchase ( Simple ( SEP ( Defined Benefit |
|Investment Company (if different than Service Provider): |
|Total Assetsin Plan: |$ |
|Estimated Annual Contribution: EE + ER = Total |
|(employee: $_______________ + employer: $_______________ = Total: $_______________) |
|Number of Eligible Employees: ______ Participants: ______ Terminated (still in plan): ______ |
|Matching Formula (%)________________________________: ( annual ( payroll ( discretionary |
|Vesting Schedule: |
|Eligibility Requirements: Entry Date: |
|Roth 401(k) or Roth 403(b): ( Currently provided ( Wish to be added (if available) |
|Number of Investment Options: |
|Plan Architecture: ( variable annuity ( mutual funds (open architecture) ( mutual funds(one fund family) |
|Payroll |
|( Outside Payroll Provider: ______________________ ( Payroll done in-house |
|Payroll Frequency: ( monthly ( bi-weekly (26 pay) ( bi-monthly (24 pay) |
|Request for Proposal |
|Date Proposal is Needed: ___/___/ RFP Request: ( TCA Quote only ( Multi vendor RFP |
|Other Information: |
|Verity Advisor Information |
|Name: Michael DeCamillis | |
| | |
|Email: mdecamillis@ |Target Date for Implementation ____/____/____ |
| | |
|Phone: (919) 490-6717 ext. 122 | |
-----------------------
280 SOUTH MANGUM STREET
550 DIAMOND VIEW II
DURHAM, NORTH CAROLINA 27701
(919) 490-6717 (FAX) 489-8939
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