SDCooper Company - Sophisticated Benefit Plan Design

Company Questionnaire

Fax Version

Company Name:
	Address 1:
	Address 2:
	City:	State: Zip:
	Phone:	Fax :
	E-Mail:
Accountant:
	Address 1:
	Address 2:
	City:	State: Zip:
	Phone:	Fax :
	E-Mail:
Attorney:
	Address 1:
	Address 2:
	City:	State: Zip:
	Phone:	Fax :
	E-Mail:
	Employer Id#:	Tax Year End:
	Date of Inc.:	State of Inc.:
	Entity Type:
	Nature of Business:
Officers
	Pres.:
	Secy.:
	Treas.:
Company Address above will be used for Fedex shipping unless otherwise requested.

2001-2002 SDCooper Company Last modified on: 24-May-2004