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Personal Information Today's date:
Date proposal needed:
Estimated go-live date:
Please check one: New PlanExisting Plan Plan name:
Please check one: 401(k)Age-weighted
Money Purchase PensionSafe Harbor 401k
Profit SharingDefined Benefit
New ComparabilityOther (provide details below) If plan type is 'Other', provide details here:

Financial Advisor Information First name:
Last name:
Firm name:
Rep number:
Phone number:
Email:
Do you currently have a plan with NextStep (either directly or through Benefitstreet)? YesNo

Plan Sponsor Information Company name:
Total employees:
Total participants:
Type of entity: C-corpSole proprietorship
PartnershipOther
S-corp

Existing Plan Information Is this an existing or prospective client?:
Current plan provider:
Current value of plan assets:
Asset type(s): AnnuitiesSelf-directed brokerage
Mutual fundsETFs
InsuranceCollective funds
Company stock

Other Plan Information Will the plan be: BundledUnbundled If unbundled, please provide TPA info:
Firm name:
City:
State
Contact name:
Phone number:
Will the assets: Be pooled orRequire individual recordkeeping? Are loans currently permitted? YesNo Who is your preferred custodian: FidelityReliance Trust Co.
MatrixSchwab
Mid Atlantic Trust Co.TD Ameritrade
National Advisors Trust Are you interested in using model portfolios developed by NextStep partners? YesNo

Fees Financial advisor's fee: . %

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