Fundamentals of Employee Benefits Law

Size: px
Start display at page:

Download "Fundamentals of Employee Benefits Law"

Transcription

1 The first national provider of CLE Annual ALI-ABA Course of Study Fundamentals of Employee Benefits Law Thursday-Saturday, March 5-7, 2009 Orlando (Disney s BoardWalk Inn) Live Video Webcast Do you know: Why participants in a defined benefit plan have fewer reasons to worry than their counterparts in a defined contribution plan in a turbulent stock market? The ins and outs of COBRA, HIPAA, and ERISA? How a QDIA helps a plan sponsor? This course is for lawyers, accountants, actuaries, and consultants who need to know the basic laws and regulations governing employee pension and welfare benefit plans. attend on site in Orlando (Disney s BoardWalk Inn) or by Live Video Webcast

2 Fundamentals of Employee Benefits Law If you are new to employee benefits practice, or you re a general practitioner looking to expand your knowledge in this area, this annual course of study, comprising more than 17 hours of instruction, will familiarize you with the basic laws and regulations governing employee pension and welfare benefit plans. This course provides the means for lawyers, accountants, actuaries, and consultants to gain a basic knowledge of the rules that apply to both qualified and health and welfare plans covered by the Employee Retirement Income Security Act of 1974 (ERISA). The course fully examines changes resulting from the Economic Growth and Tax Relief Reconciliation Act of 2001 (EGTRRA) and the Pension Protection Act of 2006, as well as any subsequent legislation affecting plans. A small faculty of experienced practitioners takes the complex web that is ERISA and makes it accessible even to those inexperienced in the area. In addition to a comprehensive review of the basic rules of ERISA and the Internal Revenue Code, faculty members address the effects of other areas of the law, such as family and bankruptcy law, on plans. The program aims to make the complexities of employee benefits compliance, administration, design, and policy understandable. A reception for registrants and faculty following the conclusion of Thursday s program provides additional networking opportunities as well as a chance to speak directly with the faculty about particular legal issues. Time is also reserved throughout the program to address registrants questions. PLANNING CHAIR (also on faculty) Pamela D. Perdue, Summers, Compton, Wells & Hamburg, P.C., St. Louis FACULTY Brian W. Berglund, Bryan Cave LLP, St. Louis Michael A. Laing, Taft, Stettinius & Hollister LLP, Cincinnati Cynthia A. Van Bogaert, Boardman, Suhr, Curry & Field LLP, Madison, Wisconsin Roberta Casper Watson, Trenam, Kemker, Scharf, Barkin, Frye, O Neill & Mullis, P.A., Tampa ALI-ABA Staff Attorney: Amy S. Weinberg, Assistant Director, Office of Courses of Study WALT DISNEY WORLD As Disney says, Come for the meeting and then stay for the magic. Our course site hotel, the BoardWalk Inn, portrays the hustle and bustle of the bygone era of the Atlantic seaside resorts, and is located on the shores of Crescent Lake and nestled between Epcot and MGM Studios. Earn your CLE credits AND have a family vacation with our discounted group rate at the hotel, and take advantage of perks available only to those staying at and attending a meeting at a Disney property! Have fun with daytime kids programs, behind-the-scenes tours, and more! There are also specially priced Disney Meeting/Convention theme park tickets and the chance to go to the parks after hours. Disney s Magical Express provides free transportation to and from the Orlando airport to the BoardWalk Inn, as well as offering baggage handling services. For discount ticket information go to Orders must be placed by March 4, For more information on the BoardWalk Inn and Disney Conventionears perks, go to

3 Thursday, March 5, :30 a.m. Registration WEBCAST SEGMENT A Qualified Plans; Service Group Rules; and Standards of Eligibility 8:30 a.m. Introduction: Overview of Legislative and Regulatory Schemes (including what is an ERISA plan) 9:00 a.m. Types of Qualified Retirement Plans (determining what type of plan is right for a client) 9:45 a.m. Controlled and Affiliated Service Group Rules Ms. Van Bogaert 10:30 a.m. Networking Break 10:45 a.m. Minimum Standards of Eligibility Mr. Laing 11:15 a.m. Questions and Answers 11:45 a.m. Lunch Break WEBCAST SEGMENT B Coverage; Fiduciary Rules & ERISA; Nondiscrimination and Disparity; and Spousal Rights 1:15 p.m. Minimum Coverage Requirements Mr. Laing 1:45 p.m. Introduction to Fiduciary Responsibility Rules of ERISA 2:45 p.m. Networking Break 3:00 p.m. Nondiscrimination and Permitted Disparity Mr. Berglund 4:00 p.m. Spousal Rights (including QJSA/ QPSA and QDRO) Ms. Watson 5:00 p.m. Questions and Answers 5:30 p.m. Adjournment for the Day; Networking Reception for Registrants and Faculty Friday, March 6, :00 a.m. Networking Session WEBCAST SEGMENT C Top Heavy/Keogh Plans; Vesting, Reporting, and Disclosure Requirements; Plan Loans; and COBRA 8:30 a.m. Review of First Day s Topics 8:45 a.m. Special Rules for Top Heavy and Keogh Plans Ms. Van Bogaert 9:15 a.m. Minimum Vesting Requirements 9:45 a.m. Plan Loans Mr. Laing 10:15 a.m. Networking Break 10:30 a.m. Introduction to the Consolidated Omnibus Budget Reconciliation Act (COBRA) Ms. Watson 11:15 a.m. Reporting and Disclosure Requirements 11:45 a.m. Questions and Answers 12:15 p.m. Lunch Break WEBCAST SEGMENT D 401(k)s; Distributions; and HIPAA 1:45 p.m. Section 401(k) Plans Mr. Berglund 2:45 p.m. Taxation of Distributions and Required Minimum Distributions Mr. Berglund 3:30 p.m. Networking Break 3:45 p.m. HIPAA Basics (Portability and Discrimination) Ms. Watson 4:30 p.m. Questions and Answers 5:00 p.m. Adjournment for the Day Saturday, March 7, :00 a.m. Networking Session WEBCAST SEGMENT E Intersection with Other Laws 8:30 a.m. Review of Second Day s Topics 8:45 a.m. Logistics of Plan Termination 9:45 a.m. Securities Laws and ERISA Mr. Berglund 10:15 a.m. Networking Break 10:30 a.m. Ethical Issues in Representing Employee Benefit Plans Ms. Van Bogaert 11:30 a.m. Bankruptcy Laws and Employee Benefits Plans 12:00 noon Questions and Answers 12:30 p.m. Adjournment Total 60-minute hours of instruction: 17.25, including one hour of ethics 20.5 hours of CPE credit in Taxation (live program and group internet based program) THE complete CLE learning and development experience! Registrants receive: access to the archived webcast after the course online access to course materials before the course ALI-ABA s highly praised, comprehensive printed course materials unparalleled networking opportunities

4 MAIL this form together with payment to ALI-ABA: REGISTRAR, ALI-ABA, 4025 Chestnut Street, Philadelphia, PA Please attach names and addresses of additional registrants. FAX (215) Phone CLE NEWS WEB úú Attend this course live in Orlando, March 5-7, 2009, for only $1,149. Please enter registration(s) for the ALI-ABA Course of Study, Fundamentals of Employee Benefits Law. Tuition: $1,149. CP046 úú Attend this course live via the Internet with our video webcast for only $949 or view segments for only $299 each! Register me for the live video webcast ( address required). The entire program. Tuition: $949 WAP046 Webcast Segment C. Tuition: $299 WAP046C Webcast Segment A. Tuition: $299 Webcast Segment B. Tuition: $299 WAP046A WAP046B Webcast Segment D. Tuition: $299 Webcast Segment E. Tuition: $299 WAP046D WAP046E úú G G Special Offer: Register for Fundamentals of Employee Benefits Law and receive Qualified Plans: Forms, Notices, and Supplementary Materials by Pamela Perdue for $109. CP046_BK48»» We will automatically send and invoice you for supplements unless you check this circle. GO ONLINE OR CALL TO REGISTER GROUPS OF 2 OR MORE AND SAVE! Can t attend? You don t have to miss anything! Send a DVD (video) of the program, including a complimentary mp3 CD-ROM and PDFs of the course materials, for $779. AP046V Send an audio mp3 CD-ROM of the program, including PDFs of the course materials, for $579. AP046 Send the printed course materials only, for $199. SP046 Online video and audio and searchable (PDF) course materials of this program will be available. Order Qualified Plans: Forms, Notices, and Supplementary Materials by Pamela Perdue for $129. BK48 We will automatically send and invoice you for supplements unless you check this circle. úú Tuition discounts I am a recent law school graduate (< 2 years) or retired senior lawyer (65 or older). Payment is in the amount of the stated tuition or price, minus 50%. My office is a member of ALI-ABA In-House. Payment is in the amount of the stated tuition or price, minus 15%. PA residents only, add 7% sales tax to total amount (excluding course registrations). $ Total j Check enclosed (payable to ALI-ABA) Please charge to my credit card: j AMEX j DISCOVER j MasterCard j VISA Card no.: Card expiration date: / name (please print) f i r m street address suite/floor number c i t y s t a t e z i p+4 phone (include area code) signature e-m a i l a d d r e s s (r e q u i r e d f o r webcasts a n d o n l i n e subscr iptions) k e y c o d e (f r o m l a b e l ) law practice area(s) size of firm/company year entered law practice c h a n g e o f a d d r e s s? g o t o w w w.ali-aba.org /address/ SUBSTANTIAL GROUP DISCOUNTS AVAILABLE Register 2 for this course and get all subsequent registrations at 50% off (same live course only). Significant discounts are available when two or more registrants view the webcast using one computer connection or telephone. For more information and rates, go to or groupregistration@ali-aba.org.

5 Do you have the right forms for your clients qualified plans? for Qualified Plans: Forms, Notices, And Supplementary Materials (with FREE CD-ROM and 2008 Online Supplement) Counsel for any company with qualified plans Plan sponsors Pamela D. Perdue Plan administrators Family law attorneys dealing with plan assets Special price for registrants of this course: $109 FREE S/H 2007 softbound 308 pp. with FREE CD-ROM ISBN: future supplements invoiced separately and may be returned without obligation Order Code BK48 HOTEL ACCOMMODATIONS / GROUP RATE Surrender to the 1940s elegance of this Atlantic City-styled Resort, set against a breezy boardwalk entertainment complex and lake. Reserve your hotel room by February 11 to take advantage of the group rate of $270 per night. You must mention this ALI-ABA course of study to qualify for this special rate. Room reservations may be made by calling or writing to Disney s BoardWalk Inn, 2101 North Epcot Resorts Boulevard, Lake Buena Vista, FL 32830; phone (407) ; FAX (407) Confirmations will be sent by the hotel. Please read the cancellation policy carefully. GET MANDATORY CLE AND CPE CREDIT ALI-ABA is an accredited MCLE provider in AR, AZ, CA, CO, IL, ME, MO, MS, MT, ND, NM, NV, NY, OK, PA, RI, SC, VT, WI, WV, and WY. We apply for accreditation on a course-bycourse basis in virtually all other MCLE jurisdictions, including AL, DE, FL, GA, IA, ID, IN, KS, KY, LA, MN, NC, NH, OH, OR, TN, TX, UT, VA, and WA. For this course, ALI-ABA will apply for credits, including 1 ethics credit, in 60-minute states; and for 20.7 credits, including 1.2 ethics credits, in 50-minute states. In NY, this course is appropriate for both newly admitted and experienced attorneys. For specific information on CLE, CPE, or other professional accreditation, please the MCLE Team at TeamMCLE@ali-aba.org, go to or call CLE-NEWS. NASBA ACCREDITATION ALI-ABA is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville, TN Web site: For more information regarding ALI-ABAís administrative policies, such as complaint and refund, please call Customer Service at (800) CLE-NEWS. CPE credit hours for this course: 20.5 hours in Taxation (live program and group internet based program). Learning Objectives: To familiarize nonspecialists, and those who would be specialists, with the basic laws and regulations governing employee pension and welfare benefit plans. Suggested Prerequisite: Limited experience in general practice or completion of CLE/CPE Orientation Course. Level of Instruction: Basic. for more information about: registration cancellation breaks and refreshments requirements for persons with disabilities tuition assistance discounted airfares

6 also available Online CLE on-demand courses and MP3 downloads (online archive of this course free to all registrants) Digital Library course materials, articles, periodicals, books and forms Physical Library printed course materials, DVDs, and MP3 CD-ROMS CP046 Annual ALI-ABA Course of Study Fundamentals of Employee Benefits Law Thursday-Saturday, March 5-7, 2009 Orlando (Disney s BoardWalk Inn) Live Video Webcast The course materials are excellent and really fulfill their mission giving attendees the fundamentals. Overall the presenters were all very good to excellent. It is easy to see that materials have been honed and polished over time. David Murganelli, Partridge Snow & Hahn LLP, Providence, Rhode Island hours of MCLE credit, including one hour of ethics 20.5 hours of CPE credit in Taxation (live program and group internet based program) American Law Institute-American Bar Association Continuing Professional Education 4025 Chestnut Street, Philadelphia, PA NONPROFIT ORG U.S. Postage PAID ALI-ABA SUBSTANTIAL GROUP DISCOUNTS AVAILABLE for live and webcast attendance A special group rate at the Disney BoardWalk Inn and for Disney Park Ticket Packages are available for attendees. See inside for details.

Pension, Profit-Sharing, Welfare, and Other Compensation Plans

Pension, Profit-Sharing, Welfare, and Other Compensation Plans American Law Institute American Bar Association The first national provider of CLE Annual Advanced ALI-ABA Course of Study and Video Webcast Pension, Profit-Sharing, Welfare, and Other Compensation Plans

More information

From Administrative Audit Through Litigation

From Administrative Audit Through Litigation American Law Institute American Bar Association The first national provider of CLE 38 th Annual Course of Study/Video Webcast How to Handle a Tax Controversy at the IRS and in Court From Administrative

More information

Conference on Insurance and Financial Services Industry Litigation

Conference on Insurance and Financial Services Industry Litigation American Law Institute American Bar Association The first national provider of CLE Plaintiffs and Defense Perspectives Analyzed at the 14 th Annual Advanced ALI-ABA Conference on Insurance and Financial

More information

ALI-ABA Course of Study Fundamentals of Employee Benefits Law March 5-7, 2009 Orlando, Florida TABLE OF CONTENTS

ALI-ABA Course of Study Fundamentals of Employee Benefits Law March 5-7, 2009 Orlando, Florida TABLE OF CONTENTS ALI-ABA Course of Study Fundamentals of Employee Benefits Law March 5-7, 2009 Orlando, Florida PROGRAM FACULTY PARTICIPANTS FACULTY BIOGRAPHIES STUDY MATERIALS TABLE OF CONTENTS 1. Overview of ERISA s

More information

Commercial Lending and Banking Law 2009

Commercial Lending and Banking Law 2009 The first national provider of CLE Silver Anniversary (25 th Annual) Presentation! Advanced ALI-ABA Course of Study/Video Webcast Commercial Lending and Banking Law 2009 Thursday-Saturday, January 29-31,

More information

SAVE $400 See inside for details.

SAVE $400 See inside for details. 27 th Annual Advanced Course REGISTER BY APRIL 15 AND SAVE $400 See inside for details. Commercial Real Estate Financing: Strategies, Structure, and Documentation Thursday-Friday June 9-10, 2016 Miami,

More information

Fundamentals of. Securities Law. Securities Law. The most comprehensive securities fundamentals course on the market!

Fundamentals of. Securities Law. Securities Law. The most comprehensive securities fundamentals course on the market! Securities Law Annual ALI-ABA Course of Study for Inside and Outside Counsel American Law Institute American Bar Association Continuing Leadership in Professional Education Fundamentals of Securities Law

More information

Regulation D Offerings and Private Placements

Regulation D Offerings and Private Placements American Law Institute CONTINUING LEGAL EDUCATION S E E I N S I D E F O R D E TA I L S 35 TH ANNUAL ADVANCED COURSE and LIVE VIDEO WEBCAST Regulation D Offerings and Private Placements THURSDAY - SATURDAY

More information

PRODUCER ANNUITY SUITABILITY TRAINING REQUIREMENTS BY STATE As of September 11, 2017

PRODUCER ANNUITY SUITABILITY TRAINING REQUIREMENTS BY STATE As of September 11, 2017 PRODUCER ANNUITY SUITABILITY TRAINING REQUIREMENTS BY STATE As of September 11, 2017 This document provides a summary of the annuity training requirements that agents are required to complete for each

More information

Property Tax Relief in New England

Property Tax Relief in New England Property Tax Relief in New England January 23, 2015 Adam H. Langley Senior Research Analyst Lincoln Institute of Land Policy www.lincolninst.edu Property Tax as a % of Personal Income OK AL IN UT SD MS

More information

IBEW Local 716 Marital status. - - Married - spousal signature required*. First name MI Last name. City State ZIP code

IBEW Local 716 Marital status. - - Married - spousal signature required*. First name MI Last name. City State ZIP code 21 Request for Systematic Disbursement IBEW Local Union No. 716 Retirement Plan Instructions Please print using blue or black ink. Please forward this form to your Fund office to complete the 'Your Plan

More information

Request for Disbursement Vermont State Teachers Retirement System 403(b) Plan

Request for Disbursement Vermont State Teachers Retirement System 403(b) Plan Instructions Request for Disbursement Vermont State Teachers Retirement System 403(b) Plan Please print using blue or black ink. This request must be authorized by your employer. Please forward this form

More information

Older consumers and student loan debt by state

Older consumers and student loan debt by state August 2017 Older consumers and student loan debt by state New data on the burden of student loan debt on older consumers In January, the Bureau published a snapshot of older consumers and student loan

More information

The Acquisition of Regions Insurance Group. April 6, 2018

The Acquisition of Regions Insurance Group. April 6, 2018 The Acquisition of Regions Insurance Group April 6, 2018 Forward-Looking Statements This presentation contains "forward-looking statements" within the meaning of the Private Securities Litigation Reform

More information

Please print using blue or black ink. Please keep a copy for your records and send completed form to the following address.

Please print using blue or black ink. Please keep a copy for your records and send completed form to the following address. 20 Disbursement for Beneficiary/QDRO Account IBEW Local Union No. 716 Retirement Plan Instructions About You Please print using blue or black ink. Please keep a copy for your records and send completed

More information

Attention; Benefits/Human Resources office - Please send completed form to our address or fax number. Questions?

Attention; Benefits/Human Resources office - Please send completed form to our address or fax number. Questions? 21 Request for Systematic Disbursement Vermont Deferred Compensation Plan Instructions Please print using blue or black ink. Please forward this form to your benefits/human resources office to complete

More information

THE TATITLEK CORPORATION 401(K) PLAN FINAL DISTRIBUTION FORM (907)

THE TATITLEK CORPORATION 401(K) PLAN FINAL DISTRIBUTION FORM (907) Return Form To: Human Resources Department 561 East 36 th Avenue Anchorage, AK 99503 Fax (907) 334-1981 THE TATITLEK CORPORATION 401(K) PLAN FINAL DISTRIBUTION FORM (907) 278-4000 Participant Information

More information

Representing Estate and Trust Beneficiaries and Fiduciaries 2018

Representing Estate and Trust Beneficiaries and Fiduciaries 2018 ANNUAL ADVANCED COURSE and LIVE VIDEO WEBCAST Representing Estate and Trust Beneficiaries and Fiduciaries 2018 The only national course that gives you a 360-degree view of the complex issues affecting

More information

COMPARISON OF ABA MODEL RULE FOR REGISTRATION OF IN-HOUSE COUNSEL WITH STATE VERSIONS

COMPARISON OF ABA MODEL RULE FOR REGISTRATION OF IN-HOUSE COUNSEL WITH STATE VERSIONS As of September 7, 2016 2016 American Bar Association COMPARISON OF ABA MODEL RULE FOR REGISTRATION OF IN-HOUSE COUNSEL WITH STATE VERSIONS AMERICAN BAR ASSOCIATION CENTER FOR PROFESSIONAL RESPONSIBILITY

More information

State Treatment of Social Security Treatment of Pension Income Other Income Tax Breaks Property Tax Breaks

State Treatment of Social Security Treatment of Pension Income Other Income Tax Breaks Property Tax Breaks State-By-State Tax Breaks for Seniors, 2016 State Treatment of Social Security Treatment of Pension Income Other Income Tax Breaks Property Tax Breaks AL Payments from defined benefit private plans are

More information

NOTICE OF FEDERAL AND STATE TAX INFORMATION FOR PSA PLAN PAYMENTS YOUR ROLLOVER OPTIONS

NOTICE OF FEDERAL AND STATE TAX INFORMATION FOR PSA PLAN PAYMENTS YOUR ROLLOVER OPTIONS NOTICE OF FEDERAL AND STATE TAX INFORMATION FOR PSA PLAN PAYMENTS YOUR ROLLOVER OPTIONS Retain this Notice for Future Reference You are receiving this notice because all or a portion of a payment you are

More information

Comparative Revenues and Revenue Forecasts Prepared By: Bureau of Legislative Research Fiscal Services Division State of Arkansas

Comparative Revenues and Revenue Forecasts Prepared By: Bureau of Legislative Research Fiscal Services Division State of Arkansas Comparative Revenues and Revenue Forecasts 2010-2014 Prepared By: Bureau of Legislative Research Fiscal Services Division State of Arkansas Comparative Revenues and Revenue Forecasts This data shows tax

More information

The Lincoln National Life Insurance Company Term Portfolio

The Lincoln National Life Insurance Company Term Portfolio The Lincoln National Life Insurance Company Term Portfolio State Availability as of 7/16/2018 PRODUCTS AL AK AZ AR CA CO CT DE DC FL GA GU HI ID IL IN IA KS KY LA ME MP MD MA MI MN MS MO MT NE NV NH NJ

More information

ehealth, Inc Fall Cost Report for Individual and Family Policyholders

ehealth, Inc Fall Cost Report for Individual and Family Policyholders ehealth, Inc. 2010 Fall Cost Report for and Family Policyholders Table of Contents Page Methodology.................................................................. 2 ehealth, Inc. 2010 Fall Cost Report

More information

THE WINDERMERE REAL ESTATE 401(k) PLAN FOR EMPLOYEES DISTRIBUTION FORM

THE WINDERMERE REAL ESTATE 401(k) PLAN FOR EMPLOYEES DISTRIBUTION FORM THE WINDERMERE REAL ESTATE 401(k) PLAN FOR EMPLOYEES DISTRIBUTION FORM INSTRUCTIONS 1.) Please read the notice regarding the (a.) TIMING & COST OF DISTRIBUTION on this page, (b.) the DISTRIBUTION ACKNOWLEDGEMENTS

More information

2016 Workers compensation premium index rates

2016 Workers compensation premium index rates 2016 Workers compensation premium index rates NH WA OR NV CA AK ID AZ UT MT WY CO NM MI VT ND MN SD WI NY NE IA PA IL IN OH WV VA KS MO KY NC TN OK AR SC MS AL GA TX LA FL ME MA RI CT NJ DE MD DC = Under

More information

Planning Techniques for Large Estates 2018

Planning Techniques for Large Estates 2018 ANNUAL ADVANCED COURSE and LIVE VIDEO WEBCAST Planning Techniques for Large Estates 2018 LOOK INSIDE! Newly Updated to Include the Impact of Tax Reform. APRIL 25-27, 2018 AUSTIN, TX PLANNING CHAIRS (also

More information

Advanced Commercial Finance 2018:

Advanced Commercial Finance 2018: ANNUAL ADVANCED COURSE and LIVE VIDEO WEBCAST Advanced Commercial Finance 2018: Critical Issues Below the Surface High-level discussions, keen analysis, and practical guidance for the discerning practitioner

More information

Name of Applicant Soc Sec # _ / / Marital Status (Circle One): Single Married Divorced Widow(er) Name of Spouse Date of Birth / / Soc Sec # _ / /

Name of Applicant Soc Sec # _ / / Marital Status (Circle One): Single Married Divorced Widow(er) Name of Spouse Date of Birth / / Soc Sec # _ / / PLAN NUMBER 766570 20 IBEW LOCAL 102 SURETY FUND C/O I.E. SHAFFER & CO. 830 BEAR TAVERN RD 2 ND FLOOR PO BOX 1028 TRENTON NJ 08628-0230 PHONE (800)792-3666 FAX (609) 883-7560 Application for Benefits (Please

More information

Age of Insured Discount

Age of Insured Discount A discount may apply based on the age of the insured. The age of each insured shall be calculated as the policyholder s age as of the last day of the calendar year. The age of the named insured in the

More information

Request for Systematic Disbursement

Request for Systematic Disbursement Instructions About You Request for Systematic Disbursement NC 401(k) PLAN Please print using blue or black ink. Please send completed form to the following address or fax it to 1-866-439-8602. Questions?

More information

Fiduciary Tax Returns

Fiduciary Tax Returns Functions and Procedures Index Books On Line Main Directory Overview... 2 How does it work?... 3 What Information is transmitted to the Tax Service?... 4 How do I initiate this service?... 8 Do I have

More information

IRA Distribution Form

IRA Distribution Form Use this form to request distributions from your IRA account and to close an IRA. Instructions 1. Complete the form and include any necessary supporting documents. 2. Sign and send us the completed form.

More information

Request for Systematic Disbursement

Request for Systematic Disbursement Instructions Request for Systematic Disbursement ALAMEDA COUNTY DEFERRED COMPENSATION PLAN Please print using blue or black ink. Return this form to: Alameda County Treasurer s Office, Attn: DC Administration,

More information

State Trust Fund Solvency

State Trust Fund Solvency Unemployment Insurance State Trust Fund Solvency National Employment Law Project Conference - Washington DC December 7, 2009 Robert Pavosevich pavosevich.robert@dol.gov Unemployment Insurance Program

More information

Distribution of Account Balance up to $5,000 under a 457 Plan

Distribution of Account Balance up to $5,000 under a 457 Plan About You Plan number 3 0 0 4 1 1 Social Security number - - First name MI Last name Sub plan number 000001 State of Hawaii 000004 County of Maui 000002 County of Hawaii 000005 County of Hawaii Water District

More information

Massachusetts Budget and Policy Center

Massachusetts Budget and Policy Center Progressive Massachusetts 2013 Policy Conference March 24, 2013 Lasell College Newton, MA Presentation by Massachusetts Budget and Policy Center Our State Budget: Building a Better Future Together Massachusetts

More information

Introducing LiveHealth Online

Introducing LiveHealth Online Introducing LiveHealth Online Online Health Care when you need it! Meeting Members Wherever They Are 1 Why Consider Tele-Health? Convenience: Employees are able to access care at work, outside of traditional

More information

TCJA and the States Responding to SALT Limits

TCJA and the States Responding to SALT Limits TCJA and the States Responding to SALT Limits Kim S. Rueben Tuesday, January 29, 2019 1 What does this mean for Individuals under TCJA About two-thirds of taxpayers will receive a tax cut with the largest

More information

Report of Termination/Request for Disbursement Plumbers Local Union No. 1 Employee 401(k) Savings Plan

Report of Termination/Request for Disbursement Plumbers Local Union No. 1 Employee 401(k) Savings Plan Instructions About You Please print using blue or black ink. Send completed form to the following address or fax it to 1-866-439-8602. If faxing, please keep original for your records. Prudential PO Box

More information

Sub Plan number. area code

Sub Plan number. area code 617 Request for Unforeseeable Emergency Withdrawal MTA 457 Plan Instructions Please print using blue or black ink. Send completed form to the following address or fax it to 1-866-439-8602. If faxing, please

More information

TECHNOLOGY & SOFTWARE TAX BENEFITS & BURDENS

TECHNOLOGY & SOFTWARE TAX BENEFITS & BURDENS TECHNOLOGY & SOFTWARE TAX BENEFITS & BURDENS R&D Tax Credit & State & Local Tax Issues September 20, 2016 Ashley Thompson Director athompson@bkd.com JoAnna Simek, CPA Director jsimek@bkd.com 1 TO RECEIVE

More information

Tax Breaks for Elderly Taxpayers in the States in 2016

Tax Breaks for Elderly Taxpayers in the States in 2016 AL Payments from defined benefit private plans are exempt; most public systems are exempt; military and US Civil service are exempt Special Homestead ion for 65+ +25.2% +2.4% AK No PIT Homestead ion for

More information

Cost and Coverage Implications of the ACA Medicaid Expansion: National and State by State Analysis

Cost and Coverage Implications of the ACA Medicaid Expansion: National and State by State Analysis Cost and Coverage Implications of the ACA Medicaid Expansion: National and State by State Analysis Report Authors: John Holahan, Matthew Buettgens, Caitlin Carroll, and Stan Dorn Urban Institute November

More information

Benefits-At-A-Glance Plan Year

Benefits-At-A-Glance Plan Year Benefits-At-A-Glance 2015 Plan Year This report shows 2015 TriNet Passport benefit year plan options available in: AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME,

More information

Request for Disbursement

Request for Disbursement Instructions Request for Disbursement Deferred Salary Plan of the Electrical Industry Please print using blue or black ink. This request must be authorized by your Fund Office. Please forward this form

More information

Administrative handbook Aetna Funding Advantage SM

Administrative handbook Aetna Funding Advantage SM Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Administrative handbook Aetna Funding Advantage SM For self-insured groups with less than 100 eligible employees

More information

Report of Termination/Request for Disbursement

Report of Termination/Request for Disbursement Instructions Please print using blue or black ink. This request must be authorized by your employer. Please forward this form to your benefits/human resources office to complete the Your Plan Authorization

More information

Local Anesthesia Administration by Dental Hygienists State Chart

Local Anesthesia Administration by Dental Hygienists State Chart Education or AK 1981 General Both Specific Yes WREB 16 hrs didactic; 6 hrs ; 8 hrs lab AZ 1976 General Both Accredited Yes WREB 36 hrs; 9 types of AR 1995 Direct Both Accredited/ Board Approved No 16 hrs

More information

PLEASE NOTE: Required American Equity specific Product Training must be completed PRIOR to soliciting an Application to A

PLEASE NOTE: Required American Equity specific Product Training must be completed PRIOR to soliciting an Application to A PLEASE NOTE: Required American Equity specific Product Training must be completed IOR to soliciting an Application to A Signed in as: JOSEPH E GOSS LTD 3/12/2014 1:18:30 PM Home Announcements Information

More information

50% are at or over 48, 50% are at or under 48 years of age (median) Cancer/Tumor registrars taking the survey ranged in age from 22 to 69

50% are at or over 48, 50% are at or under 48 years of age (median) Cancer/Tumor registrars taking the survey ranged in age from 22 to 69 Cancer/Tumor Registrar Summary Cancer/Tumor Registrar Total Responses: 238, with 210 full-time and 28 part-time registrars responding. We also polled 72 Cancer/Tumor Registry Managers. Cancer Registrar

More information

Unemployment Insurance Benefit Adequacy: How many? How much? How Long?

Unemployment Insurance Benefit Adequacy: How many? How much? How Long? Unemployment Insurance Benefit Adequacy: How many? How much? How Long? Joel Sacks, Deputy Commissioner Washington State Employment Security Department March 1, 2012 1 Outline How many get unemployment

More information

Streamlined Sales Tax Governing Board and Business Advisory Council Update

Streamlined Sales Tax Governing Board and Business Advisory Council Update Streamlined Sales Tax Governing Board and Business Advisory Council Update Charles Collins, ADP Fred Nicely, Council On State Taxation Craig Johnson, Streamlined Sales Tax Governing Board NCSL SALT Taskforce

More information

Distribution Election for Governmental DCP 457 Plans State of Vermont Deferred Compensation Plan

Distribution Election for Governmental DCP 457 Plans State of Vermont Deferred Compensation Plan Distribution Election for Governmental DCP 457 Plans State of Vermont Deferred Compensation Plan Instructions Please print using blue or black ink. This request must be authorized by your employer. Please

More information

IRA Distribution Request Instructions and Form

IRA Distribution Request Instructions and Form IRA Distribution Request Instructions and Form 877.836.3949 203.388.2714 www.vfmarkets.com Send to: Email: US Mail: (Please submit using one method) clientservices@vfmarkets.com 120 Long Ridge Rd., 3 North

More information

Life Insurance Company Products

Life Insurance Company Products 23rd Annual Advanced ALI-ABA Conference on Life Insurance Company Products Featuring Current Securities, Tax, ERISA, and State Regulatory and Compliance Issues Thursday-Friday, November 3-4, 2005 (Grand

More information

Florida 1/1/2016 Workers Compensation Rate Filing

Florida 1/1/2016 Workers Compensation Rate Filing Florida 1/1/2016 Workers Compensation Rate Filing Kirt Dooley, FCAS, MAAA October 21, 2015 1 $ Billions 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0 Florida s Workers Compensation Premium Volume 2.368 0.765 0.034

More information

Percent of Employees Waiving Coverage 27.0% 30.6% 29.1% 23.4% 24.9%

Percent of Employees Waiving Coverage 27.0% 30.6% 29.1% 23.4% 24.9% Number of Health Plans Reported 18,186 3,561 681 2,803 3,088 Offer HRA or HSA 34.0% 42.7% 47.0% 39.7% 35.0% Annual Employer Contribution $1,353 $1,415 $1,037 $1,272 $1,403 Percent of Employees Waiving

More information

Employee Benefit Plans of Tax-Exempt and Governmental Employers Gregory F. Jacob O Melveny & Myers LLP

Employee Benefit Plans of Tax-Exempt and Governmental Employers Gregory F. Jacob O Melveny & Myers LLP PLANNING CHAIRS (also on faculty) Greta E. Cowart Winstead PC David W. Powell Groom Law Group, Chartered FACULTY FROM THE GOVERNMENT (invited) Stephen LaGarde Attorney Advisor, Office of Benefits Tax Counsel,

More information

SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS

SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS This notice explains how you can continue to defer federal income tax on your retirement plan savings in the Plan and contains important information you will

More information

2016 GEHA. dental. FEDVIP Plans. let life happen. gehadental.com

2016 GEHA. dental. FEDVIP Plans. let life happen. gehadental.com 2016 GEHA dental FEDVIP Plans let life happen gehadental.com Smile, you re covered, with great benefits and a large national network. High maximum benefits $25,000 for High Option Growing network of dentists

More information

Uniform Consent to Service of Process

Uniform Consent to Service of Process Applicant Company Name: NAIC No. FEIN: Uniform Consent to Service of Process Original Designation Amended Designation (must be submitted directly to states) Applicant Company Name: Previous Name (if applicable):

More information

Charles Gullickson (Penn Treaty/ANIC Task Force Chair), Richard Klipstein (NOLHGA)

Charles Gullickson (Penn Treaty/ANIC Task Force Chair), Richard Klipstein (NOLHGA) MEMO DATE: TO: Charles Gullickson (Penn Treaty/ANIC Task Force Chair), Richard Klipstein (NOLHGA) FROM: Vincent L. Bodnar, ASA, MAAA RE: Penn Treaty Network American Insurance Company and American Network

More information

Medicare Alert: Temporary Member Access

Medicare Alert: Temporary Member Access Medicare Alert: Temporary Member Access Plan Sponsor: Coventry/Aetna Medicare Part D Effective Date: Jan. 12, 2015 Geographic Area: National If your pharmacy is a Non Participating provider in the Aetna/Coventry

More information

Introduction to the Individual LTC Standards of the Interstate Insurance Product Regulation Commission (IIPRC) March 2011

Introduction to the Individual LTC Standards of the Interstate Insurance Product Regulation Commission (IIPRC) March 2011 Introduction to the Individual LTC Standards of the Interstate Insurance Product Regulation Commission (IIPRC) March 2011 Karen Schutter, Executive Director, IIPRC Marie Roche, Assistant Vice President,

More information

Just The Facts: On The Ground SIF Utilization

Just The Facts: On The Ground SIF Utilization Just The Facts: On The Ground SIF Utilization The Access 4 Learning Community (A4L), previously the SIF Association, has changed its brand name due to the fact that the majority of its 3,000 members represent

More information

Benefits: Retirement. BLR 2015 Survey Series MARCH. Sponsor 2 Participant summary 3 Executive summary 4 Survey questions/data 10

Benefits: Retirement. BLR 2015 Survey Series MARCH. Sponsor 2 Participant summary 3 Executive summary 4 Survey questions/data 10 BLR 2015 Survey Series MARCH Benefits: Retirement Each month BLR conducts a nationwide survey to learn about current HR policies and practices throughout the country. On average, more than 1,800 individuals

More information

DOWNLOAD OR READ : DEVELOPMENT OF THE INCOME SMOOTHING LITERATURE VOL 4 A FOCUS ON THE UNITED STATES PDF EBOOK EPUB MOBI

DOWNLOAD OR READ : DEVELOPMENT OF THE INCOME SMOOTHING LITERATURE VOL 4 A FOCUS ON THE UNITED STATES PDF EBOOK EPUB MOBI DOWNLOAD OR READ : DEVELOPMENT OF THE INCOME SMOOTHING LITERATURE 1893 1998 VOL 4 A FOCUS ON THE UNITED STATES PDF EBOOK EPUB MOBI Page 1 Page 2 development of the income smoothing literature 1893 1998

More information

PRODUCTS CURRENTLY AVAILABLE FOR SALE. Marquis SP

PRODUCTS CURRENTLY AVAILABLE FOR SALE. Marquis SP INTEREST RATES - April 16, 2017 to May 15, 2017 Notices 1. Before soliciting or taking any annuity applications, it is required that you have completed Lafayette Life's Annuity Training and any Continuing

More information

Request for Disbursement Vermont State Teachers Retirement System 403(b) Plan

Request for Disbursement Vermont State Teachers Retirement System 403(b) Plan Request for Disbursement Vermont State Teachers Retirement System 403(b) Plan Instructions Please print using blue or black ink. This request must be authorized by your employer. Please forward this form

More information

International Trust and Estate Planning

International Trust and Estate Planning REGISTER BY SEPTEMBER 29 AND S AV E $ 2 00 * OR American Law Institute CONTINUING LEGAL EDUCATION ADDITIONAL REGISTR ANTS SAVE 50%* SEE BACK FOR D E TA I L S Y E A R S OF EXCELLENCE IN C L E 20 TH ANNUAL

More information

Federal Tax Reform Impact on 2019 Legislative Sessions: GILTI

Federal Tax Reform Impact on 2019 Legislative Sessions: GILTI Federal Tax Reform Impact on 2019 Legislative Sessions: GILTI Executive Committee Task Force on State and Local Taxation Scottsdale, Arizona November 17, 2018 Karl Frieden, COST Deborah Bierbaum, AT&T

More information

Variable Universal Life Permanent Life Insurance. Flexible premiums and potential cash value

Variable Universal Life Permanent Life Insurance. Flexible premiums and potential cash value Variable Universal Life Permanent Life Insurance Flexible premiums and potential cash value Why consider a Variable Universal Life Policy? Permanent life insurance protection, plus potential cash value

More information

State of the Automotive Finance Market

State of the Automotive Finance Market State of the Automotive Finance Market A look at loans and leases in Q4 2017 Presented by: Melinda Zabritski Sr. Director, Financial Solutions www.experian.com/automotive 2018 Experian Information Solutions,

More information

RLI TRANSPORTATION A Division of RLI Insurance Company 2970 Clairmont Road, Suite 1000 Atlanta, GA Phone: Fax:

RLI TRANSPORTATION A Division of RLI Insurance Company 2970 Clairmont Road, Suite 1000 Atlanta, GA Phone: Fax: RLI TRANSPORTATION A Division of RLI Insurance Company 2970 Clairmont Road, Suite 1000 Atlanta, GA 30329 Phone: 404-315-9515 Fax: 404-315-6558 AGENCY/BROKER PROFILE Please type your answers. Use a separate

More information

2018 National Electric Rate Study

2018 National Electric Rate Study 2018 National Electric Rate Study Ranking of Typical Residential, Commercial and Industrial Electric Bills LES Administrative Board June 15, 2018 Emily N. Koenig Director of Finance & Rates 1 Why is the

More information

Creating Your. Plan for Living /15/12

Creating Your. Plan for Living /15/12 Creating Your Plan for Living 4947 05/5/ What is a Plan for Living? You ve been saving for retirement for many years. Now s the time to create a plan designed to make sure those hard-earned savings can

More information

Getting Better Value for the Healthcare Dollar. National Conference of State Legislators Fall Forum November 30, 2011.

Getting Better Value for the Healthcare Dollar. National Conference of State Legislators Fall Forum November 30, 2011. Getting Better Value for the Healthcare Dollar National Conference of State Legislators Fall Forum November 30, 2011 NCQA History NCQA a non-profit that for 21 years has worked with federal, state, consumer

More information

Taxing Investment Income in the States New Hampshire Fiscal Policy Institute 2 nd Annual Budget and Policy Conference Concord, NH January 23, 2015

Taxing Investment Income in the States New Hampshire Fiscal Policy Institute 2 nd Annual Budget and Policy Conference Concord, NH January 23, 2015 Taxing Investment Income in the States New Hampshire Fiscal Policy Institute 2 nd Annual Budget and Policy Conference Concord, NH January 23, 2015 Norton Francis State and Local Finance Initiative Urban-Brookings

More information

Report to Congressional Defense Committees

Report to Congressional Defense Committees Report to Congressional Defense Committees The Department of Defense Comprehensive Autism Care Demonstration December 2016 Quarterly Report to Congress In Response to: Senate Report 114-255, page 205,

More information

Presented by: Matt Turkstra

Presented by: Matt Turkstra Presented by: Matt Turkstra 1 » What s happening in Ohio?» How is health insurance changing? Individual and Group Health Insurance» Important employer terms» Impact small businesses that do not offer insurance?

More information

Financial Capability Conference Ramsey Alwin, Senior Director, Economic Security October 26, 2012

Financial Capability Conference Ramsey Alwin, Senior Director, Economic Security October 26, 2012 Financial Capability Conference Ramsey Alwin, Senior Director, Economic Security October 26, 2012 NCOA - National Council on Aging NCOA is a nonprofit service and advocacy organization. Our mission is

More information

Domestic violence funding reduced from $1,253,000 to $1,000,000. $53,000 to fund elder law hotline eliminated.

Domestic violence funding reduced from $1,253,000 to $1,000,000. $53,000 to fund elder law hotline eliminated. Court Fees and Fines and State Appropriations by State* 2009-10 Amounts, Major Changes from 2009 Legislative Sessions Noted Revised 3/8/10 (**See note below related to court fees and fines) State Court

More information

2017 WORKBOOK. Mandatory LTC Training

2017 WORKBOOK. Mandatory LTC Training 2017 WORKBOOK Mandatory LTC Training ABOUT THE AUTHOR EDUCATION CREDIT AND YOUR CERTIFICATE OF COMPLETION LTC Connection specializes exclusively in LTC insurance training and education and has been working

More information

Obamacare in Pictures. Visualizing the Effects of the Patient Protection and Affordable Care Act

Obamacare in Pictures. Visualizing the Effects of the Patient Protection and Affordable Care Act Visualizing the Effects of the Patient Protection and Affordable Care Act Fall 2012 expands dependence on government health care dumps millions into Medicaid and creates new federal subsidies for government-approved

More information

Medicaid in an Era of Change: Findings from the Annual Kaiser 50 State Medicaid Budget Survey

Medicaid in an Era of Change: Findings from the Annual Kaiser 50 State Medicaid Budget Survey Medicaid in an Era of Change: Findings from the Annual Kaiser 50 State Medicaid Budget Survey Robin Rudowitz Associate Director, Kaiser Commission on Medicaid and the Uninsured The Henry J. Kaiser Family

More information

Supplemental Nutrition Assistance Program (SNAP) Preliminary Authorization of Food Purchasing and Delivery Services for the Elderly or Disabled

Supplemental Nutrition Assistance Program (SNAP) Preliminary Authorization of Food Purchasing and Delivery Services for the Elderly or Disabled Food and Nutrition Service (FNS) Supplemental Nutrition Assistance Program (SNAP) Preliminary Authorization of Food Purchasing and Delivery Services for the Elderly or Disabled Request for Volunteers (RFV)

More information

SCHIP: Let the Discussions Begin

SCHIP: Let the Discussions Begin Figure 0 SCHIP: Let the Discussions Begin Diane Rowland, Sc.D. Executive Vice President, Henry J. Kaiser Family Foundation and Executive Director, Kaiser Commission on for Alliance for Health Reform February

More information

Charts with Analysis: Tax Tax Type: Sales and Use Tax Topic: Cash for Clunkers Payments

Charts with Analysis: Tax Tax Type: Sales and Use Tax Topic: Cash for Clunkers Payments Effective July 1, 2009, until November 1, 2009, the federal government has enacted the Consumer Assistance to Recycle and Save (CARS) Program, Title XIII of PL 111-32 (2009), 123 Stat. 1859. The program,

More information

2018 ADDENDUM INSTRUCTIONS

2018 ADDENDUM INSTRUCTIONS 2018 ADDENDUM INSTRUCTIONS FEBRUARY 22, 2019 UPDATE: 2018 MUNICIPAL REFERENCE BOOK 1. DELAWARE funds are listed on page 15. You may note on page 15 to see the addendum for additional Delaware funds. The

More information

2017 Supplemental Tax Information

2017 Supplemental Tax Information 2017 Supplemental Tax Information We have compiled the following information to help you prepare your 2017 federal and state tax returns: - Percentage of income from U.S. government obligations - Federal

More information

medicaid a n d t h e How will the Medicaid Expansion for Adults Impact Eligibility and Coverage? Key Findings in Brief

medicaid a n d t h e How will the Medicaid Expansion for Adults Impact Eligibility and Coverage? Key Findings in Brief on medicaid a n d t h e uninsured July 2012 How will the Medicaid Expansion for Adults Impact Eligibility and Coverage? Key Findings in Brief Effective January 2014, the ACA establishes a new minimum Medicaid

More information

The conference is pleased to have the University of San Diego School of Law as a co-sponsor of this year s conference.

The conference is pleased to have the University of San Diego School of Law as a co-sponsor of this year s conference. Jeremiah Long Memorial 21 st Annual National Conference on LIKE-KIND EXCHANGES UNDER SECTION 1031 I.R.C. October 19 21, 2016 San Diego, California Sheraton San Diego Hotel & Marina PRESENTED BY: 1031 Advanced

More information

Yolanda K. Kodrzycki New England Public Policy Center Federal Reserve Bank of Boston

Yolanda K. Kodrzycki New England Public Policy Center Federal Reserve Bank of Boston The Growing Instability of Revenues over the Business Cycle: Putting the New England States in Perspective Yolanda K. Kodrzycki New England Public Policy Center Federal Reserve Bank of Boston Lincoln Institute

More information

Who s Above the Social Security Payroll Tax Cap? BY NICOLE WOO, JANELLE JONES, AND JOHN SCHMITT*

Who s Above the Social Security Payroll Tax Cap? BY NICOLE WOO, JANELLE JONES, AND JOHN SCHMITT* Issue Brief September 2011 Center for Economic and Policy Research 1611 Connecticut Ave, NW Suite 400 Washington, DC 20009 tel: 202-293-5380 fax: 202-588-1356 www.cepr.net Who s Above the Social Security

More information

ELITE 10 & 15. Make your money work for the long term. Fixed Indexed Annuity and Liquidity Rider

ELITE 10 & 15. Make your money work for the long term. Fixed Indexed Annuity and Liquidity Rider PERFORMANCE ELITE 10 & 15 Fixed Indexed Annuity and Liquidity Rider Make your money work for the long term. This material is provided by Athene Annuity and Life Company headquartered in West Des Moines,

More information

The State Tax Implications of Federal Tax Reform Legislation

The State Tax Implications of Federal Tax Reform Legislation The State Tax Implications of Federal Tax Reform Legislation Executive Committee Task Force on State and Local Taxation Phoenix, Arizona January 14, 2017 Joe Crosby, Multistate Associates Karl Frieden,

More information

36 Million Without Health Insurance in 2014; Decreases in Uninsurance Between 2013 and 2014 Varied by State

36 Million Without Health Insurance in 2014; Decreases in Uninsurance Between 2013 and 2014 Varied by State 36 Million Without Health Insurance in 2014; Decreases in Uninsurance Between 2013 and 2014 Varied by State An estimated 36 million people in the United States had no health insurance in 2014, approximately

More information

PLAN TODAY AND HELP SECURE YOUR FUTURE.

PLAN TODAY AND HELP SECURE YOUR FUTURE. PLAN TODAY AND HELP SECURE YOUR FUTURE. GROUP LONG TERM CARE INSURANCE Underwritten by Genworth Life Insurance Company 38682CV 01/28/07 38682CV_SCPMG 03/01/14 This brochure contains educational information

More information

NEW ACCOUNT & CREDIT APPLICATION. SHIP TO: (If different from Bill To) How would you like to receive invoices? (Choose 1) Fax ( /Fax#)

NEW ACCOUNT & CREDIT APPLICATION. SHIP TO: (If different from Bill To) How would you like to receive invoices? (Choose 1)  Fax ( /Fax#) HOLIDAY HOUSE DISTRIBUTING NEW ACCOUNT & CREDIT APPLICATION New Request Update Existing BILL TO: Legal D.B.A.: Street Address: City: County: State: Zip: Contact: Title: SHIP TO: (If different from Bill

More information