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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