Plan Design Information Form BUSINESS INFORMATION

Transcription

1 T (801) F (801) W hawkinsretirement.com Plan Design Information Form BUSINESS INFORMATION Referred by: Phone: Employer Legal Name: dba: Primary Contact: Phone: Fax: Employer Tax ID (EIN): Calendar Year-end Fiscal Year-end: Principal Business Activity: Date Business Commenced: Type of Entity: S-Corp C-Corp LLC Partnership LLC S-Corp Partnership Other: Payroll: In-House Outside Provider: Phone: CPA: Phone: Legal Council: Phone: Investment Advisor: Phone: PLAN INFORMATION Plan Name: 5500 Plan # (List Plan Name as you wish it to appear on all Participant reports) Plan Original Effective Date: Takeover Date: Plan Year Begins: Jan 1 or Month Day Plan Year Ends: Dec 31 or Month Day Investment Platform: Will the Plan use individual brokerage accounts? Yes No Authorized Signer(s) (authority to approve loans & distributions): Full Name & Plan Trustee(s): Full Name(s) & (s) OWNERSHIP Please List ALL owners of the Company and their ownership percentage (attach additional sheet if necessary): Name Own Name Own Are there any other companies owned by the same owners (or family members of owners) listed above? Yes No If yes, please fill out the information below as well as on page 4 under "Affiliated Companies" (attach additional sheet if necessary): Company Owner of Ownership

2 ELIGIBILITY Minimum age 21 Other Minimum Age: Exclude Part-time (less than 1,000 hrs/yr) One Year Service Requirement Other Service Requirement Other Possible Exclusions (by job class) Notes: ENTRY DATE Annual Semi-Annual Quarterly Monthly Other: Notes: : COMPENSATION (note that exclusions may be subject to additional testing) Does the plan exclude compensation? Yes No Fringe Benefits? Yes No Bonus? Yes No Overtime? Yes No Other: VESTING Count Years of Service from: Hire Date Plan Start Date Credit Service with Predecessor Employer? Yes Former ER Name: No VESTING SCHEDULE: (Profit Sharing Discretionary Match) 6 Year 5 Year 3 Year Cliff Other: Year 1 0 Year 1 20 Year 1 0 Year 1 Year 2 20 Year 2 40 Year 2 0 Year 2 Year 3 40 Year 3 60 Year Year 3 Year 4 60 Year 4 80 Year 4 Year 5 80 Year Year 5 Year Year 6 LOANS & DISTRIBUTIONS Participant Loans Allowed? Yes No Number of Loans Allowed? One Two Other: Purpose of Loan? Any Purpose Hardship Only All Sources Specify: Hardship Distributions Allowed? Yes No All Sources Specify: In-Service Distributions Allowed? Yes No Age: All Sources Specify: (Note that in-service distributions of employee deferrals, ROTH, Safe Harbor contributions, QNEC, & QMAC, are not allowed until age 59 ½) Notes: 401(k) MATCH (Vesting Schedule Applies) Discretionary 25 per $1 to 4 of pay 50 per $1 to 6 of pay Other: Last day service requirement for match: Yes (annual funding only) No Match funded: Weekly Bi-weekly Semi-Monthly Monthly Annual N/A Other: Hours required for match: 1, Other:

3 SAFE HARBOR (Requires 100 Vesting) Safe Harbor Match Safe Harbor Non-elective 100 first 3 plus 50 next 2 3 Required Company Contribution Enhanced Match: $1 to $1 of: of Plan Compensation True Up? Yes No (if no match must be funded each pay period) AUTOMATIC ENROLLMENT Does the plan offer automatic enrollment? Yes No Effective date: EACA (Eligible Automatic Contribution Arrangement) QACA (Qualified Automatic Contribution Arrangement) 3 non-elective 100 first 1 plus 50 next 5 Enhanced match up to True Up (match only) Yes No (if no match must be funded each pay period) Vesting year cliff Other 1 year 2 year Applicable to Employees: All EE<Minimum New Hire Only Employed as of: Initial Election: Annual Increase: or Auto Enroll Max (6 min & 10 max for QACA): or N/A Election: PreTax ROTH INVESTMENT DECISIONS Employees make investment decisions Employer makes investment decisions Other: PAYROLL FREQUENCY Weekly Bi-Weekly Semi-Monthly Monthly Other: TYPES OF CONTRIBUTIONS PROVIDED UNDER THE PLAN Salary Deferrals Roth Employer Contributions (Profit Sharing) Matching Contributions Safe Harbor Match Safe Harbor Employer (Non-elective) Qualified Non-elective (QNEC's) Qualified Match (QMAC's) COMPANY CONTRIBUTION FORMULA Hours required for Profit Sharing? 1, Other: Last Day Service Requirement for Profit Sharing? Yes No Pro Rata Contribution (equal percentage of pay) Integrated Contributions (benefits highly paid) Modification of Integration Level is: (may not exceed 100 of the Taxable Wage Base) New Comparability Allocation (different percentage of pay to each group) Each Participant is in his/her own allocation group A separate discretionary contribution will be made to the following allocation groups: Group 1: Group 4: Group 2: Group 5: Group 3: Group 6: Special Rules: Family Members are in separate allocation group Participants who do not receive Minimum Gateway Contribution are in separate allocation group

4 EMPLOYEE CONTRIBUTION CHANGES The first day of each calendar quarter The first day of each calendar month The first day of each Plan Year The beginning of each payroll period Other: SALARY OR ROTH DEFERRALS Deferrals will become effective on this date: NOTES

5 AFFILIATED COMPANIES (Please fill out details for any Affiliated Companies listed under Ownership on pg. 1) *Warning: Owners & the DOL may have different opinions regarding who is covered Do the owners (or family members of owners) have Ownership Interest in other businesses? Yes No Are other Employers adopting this plan? Yes No Possibly exclude affiliated companies in the Plan? Yes No 1 Legal Name: dba: 2 Legal Name: dba: 3 Legal Name: dba: