Retirement Plan Administration Quote Request

Please fill out completely. Thank you.

COMPANY INFORMATION
Name of Business:
Address:
City:	State: Zip:
Contact Person:
Phone:	Fax:
Email:
Website:
Full-Time Employees:	(Employees working 20+ hours per week or works 1,000+ hours per year.)
Existing Plan?	Yes No (If NO, skip to NEW PLAN DESIGN section)

CURRENT RETIREMENT PLAN
Current Plan Type: (Check all that apply) Copy of current adiption aggreement/plan document	Profit Sharing Money Purchase Defined Benefit
	401(k)/401(k) Employer Match Yes No
	403(b)/403(b) Employer Match Yes No
	ESOP Comparability Target Benefit
	Age-Weighted Cross-Tested Other
Current Plan Assets Total:

Current Asset Types: (Check all that apply) Copy of current investment statement	Mutual Funds ETF’s (Exchange Trades Funds)
	Individual Stocks
	Self-Directed Brokerage Accounts Company Stock
	Group Annunity/Insurance Contracts
	Bonds Money Manager

Current Plan Services: (Check all that Apply)	Internet Access for Account Information
	Internet Access for Account Transactions
	24-hour Voice Response System for Account Information and Transactions
	Daily Balance Accounting
	Self-Directed Brokerage Account
	Asset Allocation Models Investment Advice
	Customer Service Assistance for Participants

What are the features, benefits or services that you DO like with your existing plan?:
What are the features, benefits or services that you DO NOT like or would like to chage with your existing plan?:

NEW PLAN DESIGN
Contributions: (Check all that Apply)	Employer Profit Sharing Contributions
	Employer Matching Contributions
	Employer Does Not Want to Contribute to the Plan
	Employees Fund 100% of Their Retirement Plan
	Employees Fund Part of Their Retirement Plan

Consistency: (Check all that Apply)	Discrentionary Contributions
Consistency: (Check all that Apply)	Mandatory Contributions

Is there a group of employees that you would like to “favor” with regard to contribution amounts?
Are there any additional benefits or services that you would like to offer participants?

Feasibility Study	Would you like Vantage Benefits Administrators to provide a comparison study that will show the differences/effects of various plan designs? Yes No