Below is the 401k Solution Order Form for companies that do NOT currently sponsor a retirement plan. For any plan customization item about which you are undecided or would like some help or additional information, please mark the "Unsure..." button.

401k Solution First Plan Order Form for companies with no previously established 401k plan or other company retirement plan
1. Will this be your company's first 401k plan or are you replacing an already-existing plan?	First 401k plan Already-existing 401k plan to be converted to a 401k Solution plan (STOP!!! Please use our Plan Conversion Order Form instead of this New Plan Order Form if your company already has a 401k plan. Thank You.)
Part I: Company Information...
2. Company name
3. Contact person
4. Title
5. Phone	-
6. Fax	-
7. E-mail
8. Your 401(k) decision-making role	Sole decision maker Making recommendation Leading committee to gather information Member of committee to evaluate options Interested employee Unsure. Please contact me with help regarding this item.
9. Company address
10. City
11. State	Zip
12. Company mail-to address	Use address listed above as mail-to address Use other address
13. Federal ID number
14. Date business commenced
15. Type of entity	Please indicate your company's type: C Corporation Professional Service Corporation S Corporation Limited Liability Company taxed as (check one)... Partnership or Sole Proprietorship Corporation S Corporation Sole Proprietorship Partnership other:  Is your company a member of a controlled group? more info Yes    No   Unsure. Please contact me regarding this question. Is your company a member of an affiliated service group? more info Yes    No   Unsure. Please contact me regarding this question.
16. # of employees on payroll
17. Fiscal year on which business is run	January 1 - December 31 Other:  Unsure. Please contact me regarding this item.
18. Computer system	401k Solution runs over the Internet. For our records, which system do you use most frequently? Desktop PC MAC Unsure. Please contact me regarding this item.
Part II: Plan Information...
Note:	Complete the below ONLY if the 401k Solution plan will be your company's FIRST retirement plan ever. If your company already has a retirement plan and will be having 401k Solution replace that plan, please use our Conversion Plan Order Form instead of this New Plan Order Form. Thank You.
19. Potential size, in number of employees, of your 401k Solution plan	Number of full-time employees currently on your payroll 2-4 5-10 11-15 16-20 21-25 26-30 31-35 36-40 41-45 46-50 more than 50 Unsure. Please contact me regarding this item.
20. Plan Administrator	Most 401k Solution customers name their company as their official 401k Plan Administrator, though you do have the option of designating an outside party to handle your 401k plan administration via 401k Solution. Who will serve as Plan Administrator for your 401k Solution plan? If you don't know, mark the "Unsure. Please contact..." box. Our company: Have our employees contact (name, title) by calling or e-mailing when need be. Outside party: Contact (name, title) of (company name) ; tax ID number is ; phone number is , e-mail address is , mailing address is (including city, state and zip) . Unsure. Please contact us about naming a Plan Administrator.
21. Plan Trustee(s)	Who at your company will serve as your 401k Solution plan's Trustee(s)? Please include his/her/their title(s) (such as "CFO"), as applicable. If you are unsure who will serve as your plan's trustee(s), mark the "Unsure. Please contact..." box below. Trustee(s) phone number(s):  Unsure. Please contact us about naming a Plan Administrator.
22. Compliance test preferences (remember, just mark "Unsure" if you want help with any item; compliance test preferences is something people new to 401k plans usually need help with)	You have some flexibility regarding the parameters by which the IRS compliance tests your plan will have to pass each year are run. Your 401k Solution software will have your preferences hardwired into it so you can run accurate compliance tests as often as you like (we recommend monthly). 401k Solution will keep you apprised of your plan's health and help ensure your plan passes its critical year-end tests. The determination of Highly-Compensated versus Non-Highly-Compensated Employees for your plan will be based on the previous year's wages. Would you like your plan to limit the definition of Highly-Compensated Employees to "the top 20% of employees"? Not applicable: Safe harbor plan more info Yes (recommended) No Unsure. Please contact me regarding this item.
23. Age requirement for participation in 401k Solution plan	What age requirement do you want for your 401k Solution plan? None 21 Other (please specify) Unsure. Please contact me regarding this item.
24. Length of Service requirement for your 401k Solution plan?	What length of service requirement do you want for participation in your 401k Solution plan? None Three (3) months of service with the company Six (6) months of service with the company One (1) year of service with the company Other (please specify): Unsure. Please contact me regarding our 401k Solution plan length of service requirement.
25. Participation exclusions	Would you like to exclude any categories of employees from participation in your 401k Solution plan? Yes No Unsure. Please contact me regarding participation exclusions used in our existing company plan. If "Yes", please identify the classes of employees you'd like to exclude from participation in your 401k Solution plan: (check all that apply) Union members Non-resident aliens
26. Automatic enrollment	Do you want your 401k Solution plan to use automatic enrollment? more info Yes No Unsure. Please contact me regarding this item. If "Yes", what would you like the default contribution rate to be for automatically enrolled participants? Not applicable. Do not want auto enrollment used in our 401k Solution plan. 3% 4% 5% Unsure. Please contact me regarding using auto enrollment in our 401k Solution plan.
27. Employer contributions NOTE: If you plan to run your 401k as a safe harbor plan, please indicate any relevant safe harbor employer contributions at item 32 of this order form and DO NOT include your safe harbor contribution formula(s) herein under item 27 Employer Contributions. more info	Your company can contribute to plan participants' accounts in any of three ways: (1) regular matching contributions, (2) discretionary employer contributions, and/or (3) qualified nonelective contributions. Regular matching contributions (RMCs) are defined in terms of participant's elective contribution (e.g., 50¢ contributed by the employer for each dollar contributed by the plan participant). Discretionary employer contributions (DECs) are basically profit-sharing contributions, although the employer's contribution does not have to be limited to net profits. Qualified nonelective contributions (QNECs) are allocated on the basis of compensation or some other variable aside from a participant's elective contribution; they are made to ALL eligible employees regardless of whether or not the employee contributes to or participates in the 401(k) plan -- unless the QNEC is being used to satisfy ADP or ACP test corrections. As for vesting, RMCs and DECs can be subject to vesting schedules, but QNECs are always 100% vested to employees' accounts when made. 1) Will your company be making any REGULAR MATCHING CONTRIBUTIONS to employees' accounts? No regular matching contributions will be made. Our company MAY make matching contributions equal to a discretionary percentage that our company will determine at a later time. Our company WILL make regular matching contributions at a rate of % (e.g., 50%) to each dollar our participants defer into the plan. Our company WILL make regular matching contributions at a rate of % (e.g., 50%) to each dollar our participants defer into the plan, up to a maximum annual matching contribution of (check and complete one): $ per participant per year. % of the participant's compensation per year. a discretionary percentage of the participant's compensation or a discretionary dollar amount, the percentage or dollar amount to be determined by our company on a uniform basis to all participants. AND our company (check one) will will not contribute an additional discretionary percentage, to be determined by our company. Other: Unsure. Please contact me regarding regular matching contributions. 2) Would your company like to have the option of being able to make DISCRETIONARY EMPLOYER CONTRIBUTIONS (i.e., profit-sharing contributions) to employees' accounts? No, we do not want the option of even possibly making profit-sharing contributions. Yes, our company will POSSIBLY make profit-sharing contributions in an amount to be determined by our company. AND DOES NOT want contribution amounts to be limited to current or accumulated net profit. (Checking this option in no way obligates your company to making any actual contributions, it simply leaves open the possibility that you might.) Yes, our company will POSSIBLY make profit-sharing contributions in an amount to be determined by our company AND DOES want contribution amounts to be limited to current or accumulated net profit. (Checking this option in no way obligates your company to making any actual contributions, it simply leaves open the possibility that you might.) Unsure. Please contact me regarding profit-sharing contributions. 3) Would your company like to have the option of being able to make QUALIFIED NONELECTIVE CONTRIBUTIONS to employees' accounts? No (except as needed for discrimination test corrections). Yes, our company will POSSIBLY make qualified nonelective contributions in an amount to be determined by our company. (Checking this option in no way obligates your company to making any actual contributions, it simply leaves open the possibility that you might.) Yes, our company will make qualified nonelective contributions equal to % of the total compensation of all participants eligible to share in the allocations. Unsure. Please contact me regarding profit-sharing contributions.
28. Vesting of employer contributions	"Vesting" refers to ownership. For instance, if you pick Schedule D below and a plan participant leaves your company after 2 years, he or she will only be entitled to 20% of any relevant employer contributions made by your company to his or her account. The remainder will go into a pool that your company can choose to use for employer contributions owed to other participants. What vesting formula do you want to use for any employer contributions? Mark your choice for any profit-sharing contributions in column P-S Contribs and for any matching contributions in column Match Contribs. P-S Contribs Match Contribs Vesting Schedule Not applicable (no employer contributions, so no vesting) SCHEDULE A: 100% immediate vesting SCHEDULE B: 0-2 years 3 years = = 0% vested 100% vested SCHEDULE C: WARNING: not recommended due to likelihood of causing top heavy testing problems. 0-4 years 5 years = = 0% vested 100% vested SCHEDULE D: 0-1 years 2 years 3 years 4 years 5 years 6 years = = = = = = 0% vested 20% vested 40% vested 60% vested 80% vested 100% vested SCHEDULE E: 1 year 2 years 3 years 4 years = = = = 25% vested 50% vested 75% vested 100% vested SCHEDULE F: 1 year 2 years 3 years 4 years 5 years = = = = = 20% vested 40% vested 60% vested 80% vested 100% vested Other: Unsure. Please contact me regarding the vesting schedule(s) to use for our 401k plan.
29. Loans	Do you want your 401k Solution plan to allow for 401k loans (that is, for participants to borrow from their accounts)? more info Yes No Unsure. Please contact me regarding this item.
30. Investments: Investment Type (view investment listings)	Please indicate the type of investments you want for your 401k Solution plan: more info Self-Directed Brokerage Accounts only No-Load Mutual Funds only Load Mutual Funds only Unsure. Please contact me regarding the type of investments to offer within our 401k Solution plan.
31. Investments: Investment Family (view investment listings)	Please indicate the family of mutual funds and/or the brokerage account you wish to offer within your 401k Solution plan (for example, T. Rowe Price mutual funds or Charles Schwab OneSource brokerage accounts). If you have not already done so, you should look through our investment listings to view your options - or simply contact us for help by clicking the "Unsure..." button below.   Unsure. Please contact me regarding the exact investment family and/or brokerage account to offer within our 401k Solution plan.
32. Safe Harbor Designations	The IRS allows 401k plan sponsors an alternative to subjecting their 401k plans to annual discrimination testing. The safe harbor method of plan operation lets employers instead make certain contributions to the plan, with immediate vesting of the contributions to employees' 401k accounts. more info Do you want to operate your 401k Solution plan as a safe harbor 401(k) plan? Yes No (you can skip the rest of this section 32) Unsure. Please contact me regarding operating our 401k plan as a safe harbor plan. If you are choosing to operate your 401k plan as a safe harbor MATCHING CONTRIBUTION plan, which employer contribution formula would you like to employ? Not applicable (don't want to use the safe harbor method) Make a qualified nonelective contribution equal to 3% of compensation to each eligible employee's account. (Note: Qualified nonelective contributions are made to ALL eligible employees accounts, regardless of whether the persons participate in the company 401k plan.) Make a dollar-for-dollar matching contribution to non-highly-compensated employees on salary deferrals up to 3% of compensation and 50¢ to the dollar matching contributions to non-highly compensated employees on salary deferrals of 3% to 5% of compensation, making sure not to exceed these rates in any matching contributions made to highly compensated employees. (Note: Matching contributions, because they're based upon salary deferral amounts, are made only to currently-participating employees' 401k accounts.) Unsure. Please contact me regarding the type of 401k safe harbor contribution to make. If you are choosing to operate your 401k plan as a safe harbor MATCHING CONTRIBUTION plan, how often do you want your employer matching contributions to be made? Not applicable (don't want to use the safe harbor method) Annually Per payroll period Per month Per quarter Unsure. Please contact me regarding the frequency of making our 401k safe harbor employer contributions.
Part III: 401k Solution Purchase...
33. The price of your 401k Solution system (401(k) Easy Online is licensed on a calendar year basis, which requires the purchase of a new license at the beginning of each New Year) Plan Size (in number of eligible employees) 401k Solution Online Pricing for your custom 401k plan and plan administration system 2-4 eligible employee $2390 per year 5-10 eligible employees $2590 per year 11-15 eligible employees $2990 per year 16-20 eligible employees $3390 per year 21-25 eligible employees $3790 per year 26-30 eligible employees $4190 per year 31-35 eligible employees $4790 per year 36-40 eligible employees $5390 per year 41-45 eligible employees $5990 per year 46-50 eligible employees $6590 per year more than 50 eligible employees ($6590 plus $300 for each additional 5 eligible employees
34. $1495 FIRST-YEAR-ONLY setup fee (Remember, this fee, unlike the above money-back guaranteed Annual Fee, is NONREFUNDABLE but generally tax rebatable. We encourage prospective clients to try our free Demo to make sure they like 401k Solution before they have us set up a customized a system for them.)
35. TOTAL (system price + setup fee)
Part IV: Payment Preference...
NO PAYMENT IS DUE AT THIS TIME. We will contact you within 24 hours of receiving your order to confirm your designations and answer any questions you have. 36. Do you prefer to be contacted regarding your order by telephone or e-mail? Contact by phone Contact by e-mail When your 401k Solution representative calls you to go over any items about which you marked "unsure" and to collect additional information needed for your plan's official Summary Plan Description (SPD) and Prototype Plan Adoption Agreement, you will be able to pay your 401k Solution customization fee using your Visa, Mastercard, American Express Card, or by check through the mail; there is a five-day holding period on all check orders. As soon as we receive your payment we will customize your software, prepare official documents for your review, then send out your customized system. You can have your 401k up and running within two weeks -- or less! 37. How will you prefer to pay for your 401k Solution system when we contact you? credit card* via phone credit card* via e-mail check * Pension Systems Corporation does not add credit card processing fees to Mastercard or Visa transactions, but adds a $25 processing fee to all American Express transactions.
Part V: How did you hear about us?
38. One last thing before you submit your order: Please tell us how your heard about 401k Solution... Financial planning professional, friend or colleague. Please list the person and/or company name: Linked to the 401k Solution website from another website. Please tell us the name of the site and/or company sponsoring it: Web search. Please list the browser and search term(s), if you remember them (e.g., Netscape, 401k software): Business or trade publication. Please give the name of the publication: Other. Please explain:
39. Now please look over our User's Agreement, then submit your order or inquiry. (Submitting an order acknowledges that you have read and accept our User's Agreement but in no way obligates you to making any purchase.)