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REQUEST FOR PROPOSAL

Requested By:

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Your Firm Name:

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Your Firm Phone:

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Your Firm Fax:

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Your Broker/Dealer:

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Legal Name of Sponsor Company:

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Legal Plan Name:

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New Plan or Takeover:

New  Takeover  *

Eligible Participants:

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If Transferring In Please Fill Out The Following

Estimated Assets Transferred:

Amount of Recurring Deposits:

Plan Year End (month/day):

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Effective Date of Plan
(as on Adopt. Agreement):

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Surrender Fee? If so, how much:


Select Investment Vehicle being proposed:
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If Nationwide, List Compensation Table, Year wanted
(or call to discuss after submitting this form):

Any Nationwide fringe benefits you want included
(Fund Window, Fixed Funds, RIA Services):

Proposal Needed By:  / / *

 

Contact us with questions:
Phone: (920) 720-0005     Fax: (920) 725-8337