Business Owner Financial Assessment

We'd like to help you identify those areas of your business that may need attention. Please complete, checking all that apply for each statement. Thank you.

Do you know who will operate your business if you die, become disabled or retire?

	Yes	No	Not Applicable	Let's Discuss
Response

Do you have a formal succession plan for continuing your business?

	Yes	No	Not Applicable	Let's Discuss
Response

Does your successor, family and key employees all know about your future plans or succession plan for the business?

	Yes	No	Not Applicable	Let's Discuss
Response

Do you have a buy-sell agreement in place?

	Yes	No	Not Applicable	Let's Discuss
Response

Have you funded your buy-sell agreement?

	Yes	No	Not Applicable	Let's Discuss
Response

Have you reviewed your buy-sell agreement and funding arrangement in the last 2 years?

	Yes	No	Not Applicable	Let's Discuss
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Have you completed an independent business valuation?

	Yes	No	Not Applicable	Let's Discuss
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If so, when

Will your life insurance be sufficient to cover the debts, taxes, and estate settlement costs that may be due on your estate, which includes both personal and business assets?

	Yes	No	Not Applicable	Let's Discuss
Response

If your heirs have to sell the business in order to cover debts, taxes, and costs, will your family have an alternate source of income?

	Yes	No	Not Applicable	Let's Discuss
Response

Do you offer a retirement plan, life insurance, disability insurance, or other employee benefits in addition to health/medical insurance benefits?

	Yes	No	Not Applicable	Let's Discuss
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Do you maximize your annual retirement plan contributions?

	Yes	No	Not Applicable	Let's Discuss
Response

Is your business receiving a tax deduction for contributions to the plan?

	Yes	No	Not Applicable	Let's Discuss
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Are you satisfied with your company sponsored retirement plan?

	Yes	No	Not Applicable	Let's Discuss
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Do you have employees whose experience, skills or business knowledge are a key contributor to success and would be hard to replace if they left for a competitor?

	Yes	No	Not Applicable	Let's Discuss
Response

Do you have employees who are critical to day-to-day operations or manage the business when you are not there?

	Yes	No	Not Applicable	Let's Discuss
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Do you do anything special for key employees to recognize their contributions, or are all employees treated the same?

	Yes	No	Not Applicable	Let's Discuss
Response

Are your key employees critical to the continuation of your business if you were to step down, and would they stay with your designated successor?

	Yes	No	Not Applicable	Let's Discuss
Response

I'd like to discuss:

Succession Planning: to provide a smooth transition of ownership and control.Retirement Planning: to help you ensure you have sufficient income.Estate Planning: to help protect your legacy.Key Employee Planning: to retain and reward your most important employees, including you!Other

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example@example.com

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