Simple Contribution Transmittal Form
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1SIMPLE Contribution Transmittal
Use this form when remitting contributions to your Scottrade SIMPLE IRA Plan.
Please complete this form and return to your local branch office.
Date
Total Amount of Check
Check Number (make check payable to Scottrade)
Employer Account Number
Business Name of Employer
Recipient's Street Address (no P.O. Boxes)
ZIP Plus 4
City
State
Plan Administrator
Phone Number
Scottrade Account Number
Employee Deferral
Employer Match
Total Employee
Employee Name
(include check numbers)
Amount
Amount
Deposit
*
For additional contributions, please complete another transmittal form.
*SF2370*
X
Plan Administrator Signature
Date
SF2370/7-14
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