SDCooper Company - Sophisticated Benefit Plan Design

ERSOP Company Questionnaire

Fax Version

Corporation Name:
	Address 1:
	Address 2:
	City:	County: State: Zip:
	Phone:		Cell 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:
Shipping Address
	Address 1:
	Address 2:
	Phone:
Officers		Name:		Date of Birth
	Pres.:
	VPres.:
	Secy.:
	Treas.:
Census		Name	SSI#	Birth Date	Compensation
	Employee One:
	Employee Two:
Address above will be used for Fedex shipping unless otherwise requested.

2001-2002 SDCooper Company Last modified on: 10-Jan-2005