SecurePoint Retirement Program

401(a) Profit Sharing

To order enrollment booklets for this plan, please complete the following form. You'll receive a confirmation email upon successful submission of the form.

Please allow approximately 10 days for delivery. If you have any questions, please contact your Internal Sales Consultant for assistance at 800.747.5164 - Option 3.

Submitted by:

First Name

Last Name

Shipping Information:

First Name

Last Name

Address

City/Town

State/Province

ZIP/Postal Code

Phone

Plan Information

Plan Name

Plan Number

Plan Type

Number of Enrollment Booklets Needed

Number of Client Kits Needed

Third Party Management Information

Morningstar

Yes

Special Instructions

Note: Booklets will be shipped “Ground” unless specified otherwise in the box below.

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