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Purpose
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Buy a Business
Business Valuation Quote Request Form
First Name:
Last Name:
Your Title:
E-mail Address:
Phone Number:
Business Name:
Business Website:
Package Type:
Please Select
Bronze
Silver
Gold
Platinum
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
Other
If Other, please explain:
Reason for Valuation:
Please Select
Selling
Buying
Tax Purposes
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
3 Years
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.