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Name of Company
Name of Retirement Plan
Entity Type
Type of Plan
Name of Trustee
Name of Plan Administrator (if other than the Trustee)
Contact Number
Contact Email
Current Retirement Provider/Record Keeper
Current Third Party Administrator
Current Plan Asset Value
Number of Eligible Participants
Employer Matching Formula (if any)
Please indicate which is most important (check all that apply)	Plan Design Efficiency Fees/Costs Investment Options/Performance Payroll Integration Employee Education Compliance and Fiduciary Liability