RETIREMENT / PENSION CENSUS (Confidential Information) - FREE LOOK - New Solutions, New Tax Breaks !
CONTACT
First Name: Last Name: Phone Number (Including Area Code):
Email Address: Title:
Company Name: Type of Business: Years in Business:
Is there a DBA? If so, please list: Tax Year End:
EMPLOYEE INFORMATION (Confidential)
DATE OF DATE OF *PART *OWNERSHIP *RELATIONSHIP
LAST NAME FIRST NAME BIRTH HIRE SALARY TIME PERCENTAGE TO OWNER
INSURANCE & ANNUITIES
INCOME PLANNING
EMPLOYEE BENEFIT PLANS
BUSINESS PLANNING
Mendonca Insurance Services
949.954.4445
Please use the area below for any notes and don't forget to click on the SUBMIT BUTTON
Legal Structure of Business:
Approximate Contibution Desired? (Percent of pay or dollar amount)
Is a pension plan in force?
Do the owners have ownership interests on other businesses?
If so, supply details in the notes section below.
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949.954.4445
