RETIREMENT PLAN FORM

For a no-cost, no-obligation proposal, please complete this form on-line or by printing out a copy of the form. All questions must be completed to receive a proposal. Instructions regarding receiving a proposal from Saratoga are detailed at the end of this form. If you need assistance with this form, please call Saratoga Capital Management at (800) 807-3863.

1. INFORMATION ON PERSON(S) REQUESTING THE PROPOSAL
FULL NAME
NAME OF YOUR FIRM OR ORGANIZATION
YOUR MAILING ADDRESS
CITY, STATE, ZIP
TODAY'S DATE
DATE PROPOSAL NEEDED
NUMBER OF COPIES NEEDED
YOUR DAYTIME PHONE NUMBER
YOUR FAX NUMBER
2. PROPOSAL INFORMATION
Check the box to indicate the type of retirement plan the proposal is for:
401 (k)	Profit Sharing
Money Purchase	Other:
Check only one box below to indicate the type of plan proposal you wish to receive:
Full Proposal. Complete all information below.
Fee Quote Only. A specific fee schedule for the plan without a full proposal. Complete all information below.
FULL NAME OF PLAN OR COMPANY THAT THE PROPOSAL IS BEING PREPARED FOR
TOTAL NUMBER OF EMPLOYEES
NUMBER OF EMPLOYEES ELIGIBLE FOR THE PLAN (IF KNOWN)
EXPECTED ANNUAL PLAN CONTRIBUTIONS ($)
Is this a New Plan or is this a takeover of an Existing Plan?
New Plan	Existing Plan
If it is a takeover, what are the current plan assets?	$

Thank you for your proposal request. If you would like to erase all of the answers above, please click on the reset button below. To automatically submit your completed questionnaire to Saratoga, please click on the submit button below. Finally, you may submit your completed questionnaire to Saratoga via fax by printing out the questionnaire and faxing it to (734) 213-3739. Saratoga works with various independent investment professionals. One of these investment professionals may contact you to discuss your proposal.