Survey Request for ERISA Plan Number for Compliance with Federal Gag Clause Reporting Requirements Step 1 of 3 33% Contact InformationName(Required) First Last Title Phone(Required)Email(Required) Plan InformationReporting Entity Type(Required)Select OneERISA PlanChurch PlanNon-Federal Government PlanDo have a ERISA Plan Number?(Required)Select OneYesNoERISA Plan Number Do you have multiple divisions or companies under this same ERISA Plan Number?(Required)Select OneYesNoIf yes, please list the names of these entities: Add Remove Summary{all_fields} CAPTCHA