Proposal Request Form
Company Name:
Contact Name:
Phone:
Email:
Number of Employees:
Estimated Annual Payroll:

What are the main concerns when considering a plan?
    Cost     Participation     Administrative Responsibilities
    Investment Results     Other:

Employer Contribution or Match?   Yes   No

If applicable:
Current Plan Service Provider:
Current Plan Size:
Current Participation:
    
Registered representative of and securities offered through ING Financial Partners, Member SIPC.
Unlimited Benefits is not a subsidiary of nor controlled by ING Financial Partners, Inc.