Retirement Actuarial Services LLC
Business Pension Proposal Questionnaire
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Proposal Intake (Owner + Business Snapshot)
Office: 800-297-4987 • Local: 702-446-0477 • admin@rasvcs.com • retirementactuarialservices.com
Prepared for
Date
1
Business & Contact
Business Name
DBA (if any)
Owner(s)
Primary Contact
DOB (Self)
DOB (Partner)
DOB (Partner 2)
Address
City / State / ZIP
Phone
Cell
Fax (optional)
Email
Federal Tax ID # (EIN)
2
Business Details
Entity Type
Sole Prop
LLC
S Corp
C Corp
Prof. Corp
Other
Tax Return Filed
1040 Schedule C
1120S
1065
1120
Other
Nature of Business
Business Class Code
Date of Incorporation (optional)
3
Income
Complete the items that apply to your entity type (S Corp / Partnership / Schedule C).
W-2 Compensation (Current Year)
W-2 Compensation (Last Year)
W-2 Compensation (Previous Year)
Partnership (1065) – K-1 Line 14a (Current Year)
K-1 Line 14a (Last Year)
K-1 Line 14a (Previous Year)
1040 Schedule C – Line 31 (Current Year)
Schedule C – Line 31 (Last Year)
Schedule C – Line 31 (Previous Year)
4
Ownership & Payroll
How many owners are there?
Candidate ownership %
Other owners / %
Owner comp from other entity (if any)
Gross Payroll
Does the client have ownership interest in more than one entity?
Yes
No
If yes, list the entities and ownership/income details in “Notes & Priorities” below.
5
Contribution Planning
Target Annual Contribution Budget
Primary Goal (tax savings, retirement, medical, etc.)
6
Current / Prior Retirement Plans
Current/Prior Plan Administrator
Plan Type(s)
401(k)
Defined Benefit
Cash Balance
Profit Sharing
Money Purchase
Target Benefit
IRA
SIMPLE
SEP
Last Contribution Amount
Total Assets Under Management
When was the last contribution made?
Control Group / Affiliated Service Group (if applicable)
Control Group (80%+ ownership in another entity with employees)
Affiliated Service Group (10%+ income from entity with employees)
If checked, please summarize details in Notes & Priorities.
7
Notes & Priorities
Tell us what your priorities are and what is important about this strategy
This field is intentionally large for extensive notes.
Documents available (optional)
8
Certification
My signature below certifies that the information provided is accurate to the best of my knowledge. I will provide a complete employee census as required.
Type your name as an electronic signature.
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