Request for Proposal





Ownership*



Targeted Individuals or Groups



What do you expect to accomplish by setting up this plan?


Affiliated Companies

Company Name

Owner 1 / % Own

Owner 2 / % Own

Owner 3 / % Own

Owner 4 / % Own

Owner 5 / % Own


Referred by



Asset Manager


C.P.A.



*List the 5 largest owners of the employer and the percentages of ownership for each owner.

**The amount of money that will be contributed by the employer exclusive of employee contributions.
If a range of contributions is needed, enter the range.



Notes:

Complete the attached census form so that we may analyze the employer and provide options tailored to
this employer.


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