You must have JavaScript enabled to use this form. Basic Employer (Plan Sponsor) Information Name of Adopting Employer Employer Identification Number Business Address Street Address Suite or Unit City/Town State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP Date Business Started Phone Number Plan Contact Information Name of Plan Contact Plan Contact Email Phone Number Business Information Type of 401(k) Plan requested - Select -Traditional 401(k) PlanProfit Sharing PlanAutomatic 401(k)Safe Harbor 401(k)Solo 401(k) Plan Is this a new plan? Yes No Business Entity - Select -C CorporationS CorporationNon-ProfitPartnershipLimited Liability CompanySole Proprietorship Total number of employees Do you own more than one business? Yes No