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3500 Hillcrest Dr, Suite 2

Waco, TX 76708

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P.O. Box 7247

Waco, TX 76714

PHONE

(254) 741-9434

TOLL FREE

(866) 342-9434

FAX

(254) 741-9464

PHYSICAL ADDRESS

3500 Hillcrest Dr, Ste 2

Waco, TX 76708

MAILING ADDRESS

P.O. Box 7247

Waco, TX 76714

Email Shelly Rhynes

Email Patrick Rhynes

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Premium Only Cafeteria Plan Fully Flexible Cafeteria Plan Health Reimbursement Arrangement 401(k) Plan Profit Sharing Plan Money Purchase Pension Plan 403(b) Plan (School Districts) Defined Benefit Plan Not Sure

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Name

Company Name

Address 1

Address 2

City

Zip

State

Phone

Fax

Email

Number of Employees

Type of Business

Is this company part of a controlled group or affiliated service group?

Yes No

Note: If you answered yes, please explain:

Check plans you are interested in (check all that apply):

Premium Only Cafeteria Plan Fully Flexible Cafeteria Plan Health Reimbursement Arrangement 401(k) Plan Profit Sharing Plan Money Purchase Pension Plan 403(b) Plan (School Districts) Defined Benefit Plan Not Sure

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3500 Hillcrest Dr, Suite 2

P.O. Box 7247