Pattison Pension Specialists--Contact Us!

	3150 Carlisle, NE, Suite 211 Albuquerque, New Mexico 87110 Telephone (505) 889-4554 FAX (505) 889-4580
		Consultant & Associate Emails

Broker Name:
Firm:
Address:
City:
State:
Zip:
Phone Number:
Fax Number:
Email
Date Proposal Requested:
Number of Copies:

Section A: Client Company Information

Client Co. Name:

Plan Status: Assets $
New Plan
Takeover Plan
Other Plans (existing or terminated):

Corporate Structure: Corporation
"S" Corp
L.L.C.
Partnership
Sole Proprietorship
Other:

Fiscal Year End:

Plan Year End (if different):

Are there any Controlled Group/Affiliated Services Issues? Yes No
If yes, please explain:

Are any of the client's employees leased? Yes No
If yes, please explain:

Does the client maintain a Section 125 Plan? Yes No
If yes, please indicate annual amount:$

Anticipated Number of Active Employees:

Section B: Plan Objectives

The overall objective of this plan is to: Benefit All EE's
Minimize Non Key EE's
Maximize Owners
Maximize Selected EE's
Provide Minimum % to Non Key

Illustration Type: Profit Sharing
Cross Tested Profit Sharing
401(k) Profit Sharing
Cross Tested 401(k)
Money Purchase

If 401(k) illustration: Deferral %: HCE %
NHC %
Match %: up to %

Anticipated annual budget for employer contributions: Max. allowable
or $
or %