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Sole Proprietor Form

    Business Name
    Street Address
    City
    State
    Zip Code
    Mailing Address (if different from above)
    City
    State
    Zip Code
    Phone (with Area Code)
    Cell Phone (with Area Code)
    Fax (with Area Code)
    Email Address
    Owner/Sole Proprietor
    Employer Identification Number
    Plan Trustee
    % Ownership of Business
    Nature of Business (i.e. construction, medical practice, attorney)
    Business Code (6-digit NAICS number, check with your CPA)
    Date of Business Commencement
    Fiscal Year
    Plan Year (if diff. than FYE)
    CPA Name
    Street Address
    City
    State
    Zip Code
    Phone
    Fax
    Attorney Name
    Street Address
    City
    State
    Zip Code
    Phone
    Fax
    Completed By
    Date Completed