SEP Simple Retirement Plan Data Collection

Business Information

Business Legal Name(Required)

First Last

Business Phone(Required)

Business Email(Required)

Business Street Address (No PO Boxes)(Required)

Business City(Required)

Business State(Required)

Business ZIP / Postal Code(Required)

Entity Tax Structure(Required)

Company Tax ID(Required)

Tax Year End(Required)

Employees

Preferred Name of Plan

Does the business have any existing 401(k) plans?

Yes

No

Not Sure

Participant Information

First Name(Required)

Middle Name(Required)

Last Name(Required)

Date of Birth(Required)

Social Security Number(Required)

Driver's License #(Required)

Driver's License State(Required)

Driver's License Issue Date(Required)

Driver's License Expiration Date(Required)

Mobile Number(Required)

Email Address (if different from company email)

Home/Legal Street Address (No PO Boxes)(Required)

Home City(Required)

Home State(Required)

Home ZIP / Postal Code(Required)

Mailing Address (if different from legal address)(Required)

Occupation(Required)

Phone

This field is for validation purposes and should be left unchanged.

For additional questions, please call One Strategic Capital, Inc. at (206) 397-4890

or email insurance@oscfp.com.

If you would like to schedule an appointment, please go to: www.oscfp.com/whlt

Click on Appointment Type: WA Long Term Care Appointment

Select Date & Time

Enter your details

Click “Book”

249 WINSLOW WAY EAST

SUITE 100,

BAINBRIDGE ISLAND, WA

98110

f 206.397.4894

@onestrategiccapital

One Strategic Capital, Inc.

Investment advisory services provided by our affiliate, Hidden Cove Wealth Management, LLC (“Hidden Cove”), an SEC registered investment adviser. Additional information regarding Hidden Cove is available at www.hcwm.com and at https://adviserinfo.sec.gov/. Hidden Cove’s unique CRD number is 318677.

Past performance is not indicative of future results. Investing in securities involves the risk of loss, including the risk of loss of principal, which clients should be prepared to bear. Insurance products are backed by the financial strength and claims-paying ability of the issuing insurance company and may be subject to restrictions, limitations, and early withdrawal fees which vary by issuer. You should consider your unique financial circumstances and needs and the charges, risks, expenses, and investment objectives of any securities and insurance products before investing.

© Copyright 2023 One Strategic Capital, Inc.

Investment advisory services provided by our affiliate, Hidden Cove Wealth Management, LLC (“Hidden Cove”), an SEC registered investment adviser. Additional information regarding Hidden Cove is available at www.hcwm.com and at https://adviserinfo.sec.gov/. Hidden Cove’s unique CRD number is 318677.

Past performance is not indicative of future results. Investing in securities involves the risk of loss, including the risk of loss of principal, which clients should be prepared to bear. Insurance products are backed by the financial strength and claims-paying ability of the issuing insurance company and may be subject to restrictions, limitations, and early withdrawal fees which vary by issuer. You should consider your unique financial circumstances and needs and the charges, risks, expenses, and investment objectives of any securities and insurance products before investing.

© Copyright 2022 One Strategic Capital, Inc.

Powered by VSG Marketing

249 WINSLOW WAY EAST SUITE 100,

BAINBRIDGE ISLAND, WA 98110

f 206.397.4894

Investment advisory services provided by our affiliate, Hidden Cove Wealth Management, LLC (“Hidden Cove”), an SEC registered investment adviser. Additional information regarding Hidden Cove is available at www.hcwm.com and at https://adviserinfo.sec.gov/. Hidden Cove’s unique CRD number is 318677.

Past performance is not indicative of future results. Investing in securities involves the risk of loss, including the risk of loss of principal, which clients should be prepared to bear. Insurance products are backed by the financial strength and claims-paying ability of the issuing insurance company and may be subject to restrictions, limitations, and early withdrawal fees which vary by issuer. You should consider your unique financial circumstances and needs and the charges, risks, expenses, and investment objectives of any securities and insurance products before investing.

© Copyright 2022 One Strategic Capital, Inc.

Powered by VSG Marketing