Annual Questionnaire Annual TPA Questionnaire Step 1 of 4 25% Hiddentpaid(Required) Hiddenadministration_type(Required) Thank you as always for taking the time to provide us with your information this year. We realize we ask the same questions every year, this is to make certain we have the most up-to-date information. Please understand that this is to prevent potential issues for you down the road; we have your best interest in mind. Once you complete the questionnaire, you will receive a confirmation email. In that email, you will find links to complete the additional items needed in order to complete your 2023 Plan Review. We hope you find this new annual questionnaire to your liking, we have worked very hard to make this as "SMArt" as possible to alleviate the burden. Be sure to use the "SAVE" option at the bottom in case you are not able to finish in one setting. When you click "SAVE" the system will send you a link that allows you to pick up where you left off. Thank you... Rick, DeAnn, Ben, Erin, Kristi, Clinton, and RandyCompany InformationWe realize we have this on file however please complete all fields so we can ensure correct filing information and record any changes.Company Name(Required) Company Physical Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is this a new address?(Required) Yes No Company Direct Phone(Required) Is this a new phone number?(Required) Yes No Company's EIN(Required) Current Corporate Tax Structure(Required)C-CorpS-CorpLLCLLPNon ProfitGovernment AgencySole ProprietorPartnershipThis is the current corporate tax structure we have on file for you. Education, Religious, Governmental will choose "Non-Profit"Has there been a change in Corporate Tax Structure?(Required) Yes No Business Type (C-Corp, S-Corp, LLC, LLP, etc.)?Previous Tax Structure(Required)C-CorpS-CorpLLCLLPNon ProfitNew Tax Structure(Required)C-CorpS-CorpLLCLLPNon ProfitGovernment AgencyIf the business is an LLC, how is it taxed?(Required)S-CorpPartnershipOtherHas there been a change in your Business Fiscal Year End?(Required) Yes No Previous Fiscal Year End Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920New Fiscal Year End Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Are you filing for an extension on your corporate tax return? (Yes or No)(Required) Yes No OwnershipNames of owners and percentage owned(Required)First NameLast Name% Ownership Add RemovePlease click the + to add additional peopleAre there employees that are family members of owners?(Required) Yes No Names of family members of owners(Required)First NameLast NameFamily Member (Yes/No)Family Relationship Add RemovePlease click the + to add additional peopleNames and titles of officers(Required)First NameLast NameOfficer? (Yes/No)Title if an Officer Add RemovePlease click the + to add additional peopleOwnership of other businesses, affiliated service/control groups.(Required) Yes No During the plan year, did any of the current owners have or acquire ownership in any other company?Other Company, Business or Affiliates(Required)Company NameOwner First NameOwner Last Name% OwnershipDoes company provide a 401k? (yes/no)# of Employees Add RemovePlease click the + to add additional affiliates.Mergers/Acquisitions/Sales(Required) Yes No Have there been any acquisitions / mergers / or sales in the Plan Year that affects who is eligible for the Plan?Please describe.(Required) Primary ContactContact person - who should we contact with questions? Primary Contact First Name(Required) Primary Contact Last Name(Required) Contact person - who should we contact with questions? Primary Contact Phone(Required)Primary Contact Email(Required) Employee StructureNumber of W-2 employees reported on your census(Required)Anyone who received a paycheck, regardless of eligibility status. This number should match the number of employees reported on your payroll census.Did you have leased employees?(Required) Yes No Employees you have contracted for that are used as temporary/not permanent full time employees.Number of Leased Employees(Required)Did you have employees covered by a collective bargaining agreement(Required) Yes No Number of Employees covered by a collective bargaining agreement(Required) Plan InformationWere any Trustee changes made during the Plan Year(Required) Yes No Please list new Trustee(s) and who they are replacing:(Required)New First NameNew Last NameReplacing First NameReplacing Last Name Add RemoveAny resolution to terminate the plan made during the year?(Required) Yes No Date of last payroll contribution posted to the recordkeeper for the plan year:(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920This is the date that the contribution was actually posted to the recordkeeper/accounts.Does the Plan have a Qualified Default Investment Alternative?(Required) Yes No Please specify:(Required)ContributionsDo you need SMA to calculate Employer Contributions for the Current Plan Year?(Required) Yes No Employer Contribution Types Employer Match Profit Sharing Employer Match(Required)Employer Match %Up To % of Contribution Add RemoveEnter amount the employer will match up to the total amount the employee % of their contributionProfit Sharing - Maximize Owners(Required) Yes No Profit Sharing - Total Targeted Amount(Required)This is the total amount you want to contribute to profit sharing.Anticipated Contribution Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Anticipated contribution date for profit sharing.Fidelity Bond InformationIt is required through ERISA that plan fiduciaries be bonded for plan assets. A fiduciary is anyone who has access to and/or control over a plan's assets. A fidelity bond protects the plan against loss through fraud or dishonesty on the part of the plan officials. Plan fiduciaries must be insured for a minimum of 10% of the trust assets; it may not be for less than $1,000 and need not be for more than $500,000. A fidelity bond can be obtained through a business property and casualty insurance carrier.Does the Plan have a valid Fidelity Bond?(Required) Yes No Name of Company bond is through(Required) Amount of coverage(Required)Please upload a copy of the bondAccepted file types: pdf, Max. file size: 50 MB.This is not required. You can email it to TPA@sma.org or fax to 205-945-1830 if you prefer.Would you like SMA Services to assist in obtaining a fidelity bond?(Required) Yes No
