PRE-QUALIFICATION APP
The information you provide Berretz Capital Group in the application below will not be sold or disclosed to any third parties. The information is solely for our internal review process and is not mandatory. We encourage you to provide as much information as possible, however, you may skip any fields you like. We ask that you provide accurate information to the best of your ability. We guarantee that we will never sell or distribute this information.
Company Name
Business Location
*
City
State
Owner's Name
*
First Name
Last Name
Percentage of Ownership
Percentage %
Names & Percentage of Ownership for any additional Owners.
Name & Percentage of Ownership
Year Established
Year
Phone Number
*
E-mail
*
example@example.com
Company Type
*
Sole Proprietorship
Partnership
Corporation
LLC
Other
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Business Financials
Annual Revenue
Please Select
Under $1,000,000
$1,000,000 - $3,000,000
$3,000,000 - $8,000,000
$8,000,000 - $15,000,000
$15,000,000 - $25,000,000
$25,000,000+
Recurring Revenue (How much of your revenue is recurring each month?)
Less than 25%
25% - 50%
51% - 75%
76% - 100%
Office Type: (Do you rent your office, own, or office from home?)
Rent
Own
Home Office/Remote
Office SQFT: (How much square feet is your office including warehouse space?)
SQFT
Your Estimated Value of Assets at Fair Market Value. (Fair market value is not the liquidation value or depreciated value. It is the value based on selling the assets in their current condition.)
$ Estimated Fair Market Value
Inventory (at Cost)
Furniture & Fixtures
Equipment
Vehicles
Real Estate
Other (Please Describe)
What percentage of revenue is obtained by you or other business partners?
None
1-25%
26-50%
51-75%
76-100%
Unsure
What percentage of overall revenue does your largest customer represent?
1-25%
26-50%
51-75%
76-100%
No Large Customers
What percentage of the market share do you have?
Please Select
Less than 10%
10-25%
26-50%
51-75%
76-100%
What is your percentage of growth year over year?
Please Select
No Growth
1-10%
11-20%
21-30%
31-50%
51-70%
70-100%
Unsure
What is your gross profit margin?
Please Select
Less than 40%
41-50%
51-60%
61-80%
Unsure
What is your net profit margin?
Please Select
Less than 10%
11-15%
15-20%
21-30%
30%+
Unsure
Which of the following best describes your approach to financial record keeping? (Select all that apply)
We give our accountant a stack of receipts and they figure it out
Our accounting is always up to date and accurate
We keep track of things ourselves using an accounting package (i.e. QuickBooks)
We hire an accounting firm to prepare our taxes each year
We hire an accounting firm to produce “Compiled Statements” each year
We hire an accounting firm to produce “Reviewed Statements” or “Audited Statements” each year
Our accounting is only updated occasionally
Which of the following best describes your company's personal relationship with its customers? (Only select one. )
I know each of my customers by first name and they expect that I personally get involved when they buy from my company.
I know most of my customers by first name and they usually want to deal with me rather than one of my employees.
I know some of my customers by first name and a few of them prefer to deal with me rather than one of my employees.
I don’t know my customers personally and rarely get involved in serving an individual customer.
What is the percentage of each of the following as sources of new business for your company?
Outside Sales Staff
Word of Mouth
Word of Mouth & Referrals
Advertising & Website
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Staffing
Who is responsible for selling new business and recurring business?
Please Select
Me
Another Owner
Sales Staff
3rd Party Sales Company
Who is responsible for running the business? Who is the main decision maker?
Please Select
Me
Another Owner
Vice President
General Manager
Other
Who is responsible for the accounting?
Please Select
Me
Another Owner
Accounting Staff
Book Keeping Service
3rd Party Accounting Service
Do you have a sales team?
Please Select
Yes
No
Enter the number of staff members for all that apply.
Active Owners
Full Time Employees
Part Time Employees
Contract Personnel
Contract Personnel
Accounting Personnel
Managers (Not Seasonal)
(Seasonal Employees)
How many family members are included in the numbers
Submit
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