Business Name:
Business Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Owners' Percentage:
Email
example@example.com
Website:
Business Entity:
Please Select
Sub Ch S
C Corp
LLC
Partnership
Sole Proprietor
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Existing Business Information
What is the PRIMARY business/service offerd?
Supplemental lines of Business?
Last Year's Revenue
Previous Year's Revenue
Revenue 2 years Prior
Main reasoning as to why there was an increase/decrease?
Closest 2 "competitors" to your business?
Are you on speaking terms with your competitors?
What is your strongest value to your clients?
What is your time frame to FULLY exit?
So you belong to any trade associations?
Your ideal situation to exit (process)?
Are you willing to transition out over a series of years
Please Select
Yes
No
Are you willing to finance the sale of your business?
Please Select
Yes
No
What would be the terms of financing your business?
Are your staff (employees) aware that you want to exit?
Please Select
Yes
No
Are your staff (employees) willing to transition withe new owners?
Please Select
Your thoughts on your patients/clients willing to transition with the new owners?
Do you have Operating Agreement?
Please Select
Yes
No
When was your Operating Agreement last reviewed?
Do you own the location (building/real estate) you operate your business from?
Please Select
Yes
No
Is the property leased?
Please Select
Yes
No
Thoughts on what you will do when you exit the business?
If you are transitioning to a NEW business venture, do you have a business plan for the NEW venture?
Please Select
Yes
No
Other things we should know
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Financial Information
Annual Salary
Partner Annual Salary
Additional Income
Source of Additional Income
Do your business own rental property
Please Select
Yes
No
Fair Market value of the rental property
Balance owed on rental property
Business Value (based on valuation or best guess)
Cash equivalent assets
Bank related holdings (CDs, Savings, Money Markets, Checking Accounts)
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