2022-401k Special-attorney (Kristan)

Adopting Entity Information*
This will be the entity you have that will be adopting the solo 401(k) Plan
Adopting Entity EIN (Tax ID Number)
State where the entity is currently registered?*
Type of Entity:*
- C-Corporation
- S-Corporation
- LLC
- LLC (taxed with the IRS as an S-Corporation)
- Sole Proprietorship
Business Address*
Street Address Address Line 2 City State ZIP Code
Business Phone Number:*
Type of business you are doing?*
Who are the Owners/Partners of the Business? Please also include the amount of ownership each Owner/Partner has in the Business.*
Number of employees, other than you and your spouse (if any)?
Do you have Ownership in any other Company, other than the Adopting Entity?*
- Yes
- No
Do you have any Employees in the other company that you are an owner of?*
- Yes
- No
If Yes, How Many Employees?*

Investment Entity Intake Information (This is the entity that your Solo 401(k) plan will own)*
Please list below at least 3 names for the entity. List them in the order of preference
State where this Investment Entity will be set up?*
Investment Entity Address*
Street Address Address Line 2 City State ZIP Code
Who will be the owner/Member of the entity?*
This will be one or all of the accounts in the Solo 401(k) Plan.
- Single Member – My Solo 401(k) Plan (Not available if you’ve selected the Custodial Account Option)
- Single Member – My Custodial Solo 401(k) Traditional Account
- Single Member – My Custodial Solo 401(k) Roth Account
- Multi-Member – Split between my Roth and my Traditional Accounts.
- Multi-Member – Split between my 401(k) account and another plan participant’s account.
- Unsure – would like to speak with an attorney first
Please provide the investment amounts for each account that will be an Owner/Member: (if known)
Who will be the Registered Agent for the Investment Entity? Please choose only one option below*
- $125 - KKOS Lawyers will be my Registered Agent (an additional fee of $125 annually will apply)
- I will be the Registered Agent
- Other
This must be someone with a physical address in the state where the entity will be set up. We do offer the service if you dont have anyone.
If you chose "other" above please fill in the information below
First Name Last Name
Registered Agents Address*
Street Address Address Line 2 City State ZIP Code

Personal Information