Instructions for Year End Data Request

We ask that you complete and return these forms by February 15, 2010
Please note - a condensed version of all forms is included in the Short Data Request for one person plans

1. General Information Worksheet – Please complete regarding the structure of your business. This is very important when
calculating your contribution options.

2. Anniversary Notification – Please complete with all information pertaining to your employees. Please include:

A copy of the final payroll report from your payroll company or
W-2’s for each employee

3. Contribution Information – Please complete this worksheet to inform us of any receivable deposits as well as your
objectives for the 2009 Employer Contributions. Please see our "Important Deadlines for 2009 Plan Administration"

4.    Trust Holding/Asset Transaction Information – Please complete this worksheet or provide us with the Asset Statements
            for the Plan Year. (If you have already arranged for LAR Pensions to receive copies of your assets statements you may
            skip this page.)

5.    Insurance Information Worksheet – Please complete this form only if the Plan invests in Life Insurance Contracts.
                                                                 *This includes annuities*

6.    Distribution Worksheet – Please complete if distribution were paid to participants during 2009 so that we can complete
            the required 1099-R forms.

The deadline for the 1099-R forms to be mailed to the participants is January 20, 2010. In order for us to meet that deadline you must provide all of the data on the enclosed Distribution Log Sheet (page 9) and return it to us no later than January 15, 2010.

7. 5500 Form Questionnaire – Please complete regarding certain activities that may have taken place during the year.
Your annual 5500 Return cannot be completed without this information.

*Year End Data Request (one person plan)* *Year End Data Request (plans with employees)*

*Return to LAR Home*