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RETIREMENT MANAGER AGREEMENT
Checklist and Instructions
This Checklist and Instructions will guide the Employer in completion of the Retirement Manager
Agreement. The Employer must also provide the Required Information. The Employer must
sign and date this form and this form must accompany the completed and executed Retirement
Manager Agreement for implementation to proceed.
Required Information:
Please answer the following questions below regarding Employer status and plans:
1.
Type of employer
(check only one):
( ) Public/governmental
( ) Private tax-exempt (501(c)(3)) organization
( ) Public/governmental and private tax-exempt (501(c)(3)) organization
( ) Church
2.
List
all employer-sponsored
plans
, plan type (403(b), 401(a)/(k), 457(b)), and whether they
are to be included in Retirement Manager coordination:
Plan Name
*
Plan Type
*
Included in
Retirement
Manager?
**
(yes/no)
Filing DOL
Form 5500?
(yes/no)
Does Plan Include
Employer
Contribution?
(yes/no)
*
Note
: Plans should be named at the Employer level, not by vendor, e.g., “ABC School District
403(b) Plan.” If you offer multiple plans of the same type, such as an ERISA 403(b) plan and a
voluntary non-ERISA 403(b) plan, these plans must be listed separately.
**Retirement Manager is
not
responsible for compliance coordination for plans that are not
included.
Completion of Agreement:
Initial each item
below to indicate
completion:
________ 1. Please verify
Employer Legal Name
(Page 1).
________ 2. Please verify
Employer Address
for Notices (Page 9, Section 10).
________ 3. Please
Sign
and
Date
the Agreement (Page 13).
________ 4. Please complete the following (if Section 12 is marked on
Exhibit A
, Page 14):
Note: Your selections should be consistent with the Plan documents.
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