VGP 401k Registration

Please complete all the information in this form. This form is necessary for us to help design a plan that is most appropriate for your veterinary practice.
Practice Name*
Legal Company Name*
Veterinary Practice Tax ID*
Fiscal Year End*
Number of Employees*
Date of Business Inception*
Form of Entity*
(if LLC/LLP, indicate tax treatment)
Veterinary Practice Number*
Veterinary Practice Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Contact Name*

First NameLast Name
Primary Contact Email*
Primary Mobile Number*
Veterinary Phone Number*
Authorized Signer Name (if not primary contact)
Authorized Signer Email

Additional Information
Related Companies (Including but not limited to holding companies, parent companies, and sister companies)
Owners and Officers of the Company*
Family Relationships Between Owners and Other Employees*
Highly Compensated Employees (Earning over $135k in 2023)*
What is your practice revenue?*
Who is your VGP coach?*
Your Name*

First NameLast Name
Please Sign Here*

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Payroll Information