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Actuarial Disclosure Form

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Fill in the fields below and press Generate an Actuarial Disclosure. The next page will allow you to download the Word document for you to take and affix your company logo. Or you can intergrate into your Excel to quickly send the inputs for generating notices. See Example Excel for how to link to your Excel.

Disclosure Form Inputs

Plan Name

Plan Number

Year End

Valuation Date

Plan Actuary

Enrollment Number

Actuary Email

Plan Administrator

Plan Sponsor

Trustee

Generate Actuarial Disclosure

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