OSC Qualified Plan Data Request Qualified Plan Data Request Business InformationBusiness Legal Name* Business Street Address (No PO Boxes)* Business City* Business State*Please select...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificBusiness ZIP / Postal Code* Business Phone*Business EIN/TIN Primary Contact First Name* Primary Contact Last Name* Primary Contact Email Address* Entity Tax Structure*Corporation - C CorpCorporation - S CorpLimited Liability Company - C CorpLimited Liability Company - S CorpLimited Liability Company - PartnershipNon-CorporatePartnershipInvestment ClubFiscal Year End* MM DD Year Date Company Established* Month Day Year Do you have a current retirement plan? Yes No Has the business maintained a plan that is now terminated or frozen? Yes No Are there union employees? Yes No Does the business perform management functions for another organization on a regular basis?* Yes No Do the owners of the business have any ownership interest in any other business?* Yes No Unsure Corporate Profit (Last Two Years)2018 2019 2020 CPA/Tax Professional Name Company Email Address Attorney Name Company Email Address Investment Advisor/Broker Name Company Email Address Employee Benefits Broker Name Company Email Address Payroll Contact Name Company Email Address Please upload a completed census fileMax. file size: 2 GB.