Business Appraisals Platinum Package Request Quote Form

First Name
Last Name:
Your Title:
E-mail Address:
Phone Number:
Business Name:
Business Website:
Business Type:	Please Select C-Corporation S-Corporation LLP LLC FLP Partnership Proprietorship Other If Other, please explain:
State of Incorporation:
Your Business Location:
Brief Business Description:
Asset to be Valued:	Please Select Invested Capital 100% Equity Controlling Equity Interest Minority Equity Interest Other If Other, please explain:
Reason for Valuation:	Please Select Selling Buying Tax Puposes Estate Planning Litigation Fairness Opinion Solvency Opinion Buy-Sell Agreement Bank Loan Insurance Claim Marital Dissolution Shareholder Dispute ESOP Eminent Domain Other If Other, please explain:
Valuation Date (Month, Day, Year):
Type of Financial Information:	Please Select Tax Returns Financial Statements Both Neither
Financial Statements are:	Please Select Audited Reviewed Compiled None of the Above
Number of years of financial information:	1 Year 2 Years 3Years 4 Years 5 Years +
For the prior 12 months, what was the approximate sales dollars?
For the next 12 months, what do you anticipate the sales dollars to be?
For the prior 12 months, was the approximate net income?
For the next 12 months, do you anticipate the net income to be?
Does the business own real estate?	Yes  No       If Yes, Please Explain:
Are there any non-operating assets?	Yes  No       If Yes, Please Explain:
When do you need this report?
How many copies of the final report will you need?
Are there any unique circumstances surrounding the valuation of this business? If so, please explain.