ONE-PERSON-PLAN ORDER FORM
for with or without spousal participation
1. Company name
2. Contact person
3. Title
4. Phone
 - 
5. Fax
 - 
6. E-mail
7. Your 401k decision-making role Sole decision maker
Making recommendation
Leading committee to gather information
Member of committee to evaluate options
Interested employee
Unsure. Please contact me with help regarding this item.
8. Company address
9. City
10. State
Zip Code
11. Company mail-to address:
Use address listed above as mail-to address
Use other address
12. Federal ID Number
13. Date business commenced
14.Type of entity: Please indicate your company's type:
C Corporation
Professional Service Corporation
S Corporation
Limited Liability Company taxed as (check one)...
Partnership or Sole Proprietorship
Corporation
S Corporation
Sole Proprietorship
Partnership
Other:    

Is your company a member of a controlled group?
Yes No Unsure. Please contact me regarding this question.

Is your company a member of an affiliated service group?
Yes No Unsure. Please contact me regarding this question.
15. # of employees on payroll:
16. Fiscal year on which business is run
17. Computer system
PART II: PLAN INFORMATION...
18. Investments:
INVESTMENT TYPE
(view investment listings)		 Please indicate the type of investments you want for your Small Business 401k plan: (click for a pop-up window about your Small Business 401k investment options)
Self-Directed Brokerage Accounts only
No-Load Mutual Funds only
Load Mutual Funds only
Unsure. Please contact me regarding the type of investments to offer within our Small Business 401k plan.
19. Investments:
INVESTMENT FAMILY
(view investment listings)		 Please indicate the family of mutual funds and/or the brokerage account you wish to offer within your Small Business 401k plan (for example, T. Rowe Price mutual funds or Charles Schwab One Source brokerage accounts). If you have not already done so, you should look through our investment listings to view your options — or simply contact us for help by clicking the "Unsure..." button below.
Unsure. Please contact me regarding the exact investment family and/or brokerage account to offer within our Small Business 401k plan.
PART III: PURCHASE INFORMATION...
20. Small Business 401k One-Person Plan Annual Fee (assessed per calendar year)
21. Small Business 401k One-Person Plan Setup Fee (assessed one time only: at your plan's outset) (Remember, unlike the above money-back guaranteed Annual Fee, this fee is NONREFUNDABLE but generally tax relatable. We encourage prospective clients to try our free Product Demo to make sure they like Small Business 401k before they have us set up a customized a system for them.)
22. TOTAL (system price + setup fee):
PART IV: PAYMENT PREFERENCE...
23. NO PAYMENT IS DUE AT THIS TIME.
We will contact you within 24 hours of receiving your order to confirm your designations and answer any questions you have.

Do you prefer to be contacted regarding your order by telephone or e-mail?
Contact by phone
Contact by e-mail
24. When your Small Business 401k representative calls you to go over any items about which you marked "Unsure..." and to collect additional information needed for your plan's official Summary Plan Description (SPD) and Prototype Plan Adoption Agreement, you will be able to pay your Small Business 401k customization fee using your Visa, MasterCard, American Express Card*, or by check through the mail; there is a five-day holding period on all check orders.

As soon as we receive your payment we will customize your software, prepare official documents for your review, then send out your customized system. You can have your 401k up and running within two weeks - or less.

Please indicate at right your payment preference. (*Note: We do not add credit card processing fees to MasterCard or Visa transactions but do add a $25 processing fee to all American Express transactions.)
credit card* via phone
check
Part V: How did you hear about us?
25. One last thing before you submit your order: Please tell us how your heard about Small Business 401k...

Financial planning professional, friend or colleague. Please list the person and/or company name:
Linked to the Small Business 401k web site from another web site. Please tell us the name of the site and/or company sponsoring it:
Web search. Please list the browser and search term(s), if you remember them (e.g., Netscape, 401k software):
Business or trade publication. Please give the name of the publication:
Other. Please explain:
26. Now please look over our User's Agreement, then submit your order or inquiry. (Submitting an order acknowledges that you have read and accept our User's Agreement but in no way obligates you to making any purchase.)
Tell a friend about Small Business 401kTM.

Become a 401k Referral Partner

Earn $$$ for every company you refer to us that adopts a Small Business 401k self-service 401k plan.
Contact us to sign up!