Business Declaration Form

Business Declaration Form

Business Info
Business Name
Industry
Description
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Legal Info
Year of Establishment
Length of Current Owner(s)
Legal Structure
Is business generating profit?
No. of partners
No. of Employees
Reason for Selling
Infrastructure
Size of premises
Length of lease
Does the Business have tangible Assets?
Do you have Audited Financial?
What is average EBITDA (Monthly Profit)
Does the business have established / managed books of accounts?
How much is Owner Salary?
Any Debt / Loan?
Any Lawsuits or civil suits?
How much commitment to work does the business require?
General Expenses Break Up

Rows	Values
Cost of Revenue
Pay Roll
Lease Amount
Communication
Utilities
IT
Maintenance
Insurance
Misc.
Total

Assets & Liabilities

Rows	List of Item	Value of Item
Capital assets
Operating Assets
Equipment
Automobiles
Inventory
Furniture and Fixtures
Accounts Receivables
Securities & Deposits
Contractual / Recurring Revenue
Customer Data Base
Account Payable
Financing
Liens

Financials

Rows	Year 1	Year 2	Year 3
Revenue
Cost of Revenue
Gross Profit
Operating Expenses
Payroll
General Expenses
Total Expenses
Net Profit before Tax
Tax
Net Profit

Business History & Background
Business Model
Business Offer ( Your offer / Demand)
Remarks
Owner Declaration:
Owner/s Name:

First NameLast Name
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: