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Insurance and Financial Services

Insurance and Financial Services

Thank you for providing information about your business—this helps me prepare an accurate appraisal. The form takes around 90–120 minutes to complete and can be saved and returned to anytime.

33Questions

1
Business Trading Name
2
Your InformationPlease provide the following:
Your Full Legal Name
Your Phone Number
Your Email Address
3
Please List all Shareholders:
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Ok
4
Please List all Directors:
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Ok
5
Business Location(s)
6
Financial Service Provider Number(if applicable)
if N/A - leave this blank
7
What year did the business start?
8
Basic historyA brief explanation of how the business has grown to where it is today including involvement of key people ...
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9
Describe your specialties / place in the market:
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10
What's your reason for selling?
11
Which of the following types of financial or insurance services does your business provide?Please select all that apply...
General Insurance
Life/Health Insurance
Kiwisaver
12
Number of Active Clients
13
Number of Active PoliciesProperty, material damage, public indemnity, business interruption
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14
Total Annual Premium
15
Client Turnover Last Financial Year Gained / Lost
16
Generate Net Gain (loss)is this more or less than an average year?
17
Average time clients on book Estimate Percentage
Please Select
Please Select
0-2 Years
2-5 Years
5-10 Years
10+ Years
18
Number of Inactive Clients on Database?
19
How does the book generate renewal revenue for you?
Total fees earned last financial year
Total brokerage last financial year
20
Number of Active Clients
21
Number of Active PoliciesDeath benefit, Trauma, Disability, Income Protection, Health, Group
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22
Total Annual Premium
23
Client Turnover Last Financial Year Gained / Lost
24
Generate Net Gain (loss)is this more or less than an average year?
25
Average Time Clients on book?Estimated Percentage
Please Select
Please Select
0-2 Years
2-5 Years
5-10 Years
10+ Years
26
Number of Inactive Clients on Database?
27
How is your income comprised?
Please Select
Please Select
0.5% - total earned in this range
6 - 10% - total earned in this range
11 - 15% - total earned in this range
15%+ - total earned in this range
28
Number of Active Clients
29
Total Client Funds
30
Average Time Clients Invested?Estimated Percentage
Please Select
Please Select
0-2 Years
2-5 Years
5-10 Years
10+ Years
31
How does the book generate renewal revenue for you?
Total fees earned last financial year
Total trial commission earned last financial year
32
Revenue from fees, commission, trail income, brokerage
Referring to the P&L statement (Statement of Financial Performance) in your accounts
33
Other Revenue Earned
Referring to the P&L statement (Statement of Financial Performance) in your accounts
34
ExpensesOwner salary (do not record drawings), rent, staff excluding owner, depreciation, other
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35
One off ExpensesNote any one-off expenses – items which will not reoccur (by year)
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36
Record any other financial benefit you take out of the business which is recorded as an expense in the profit & loss statement(Vehicle expense / travel expense / other)
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37
Attach Financial Statements (P&L, management accounts, etc.)Upload any relevant financial documentation regarding the business
Drag and drop files here
Select files to upload
Cancelof
38
Number of Staff
39
Roles, Responsibilities, Qualification / Licence, Reports to?
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40
Are any staff expected to remain with the business after sale?
YESNO
41
Please provide more detail about remaining staff
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42
Technology Platforms / CRM systems used
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Means of holding and accessing documentation and information
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44
F.A.P License details
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Have you had any compliance issues in the past 5 years?
YESNO
46
Please provide more detail on compliance issues
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47
Your estimation of the extent to which you are administratively tidy & efficient, and fully compliant with respect to:
Processes
File Structure – visible / intuitive
Record Keeping
Nature of Proposals
Row 0, Column 0Row 0, Column 1Row 0, Column 2Row 0, Column 3Row 0, Column 4
Row 1, Column 0Row 1, Column 1Row 1, Column 2Row 1, Column 3Row 1, Column 4
Row 2, Column 0Row 2, Column 1Row 2, Column 2Row 2, Column 3Row 2, Column 4
Row 3, Column 0Row 3, Column 1Row 3, Column 2Row 3, Column 3Row 3, Column 4
Processes
File Structure – visible / intuitive
Record Keeping
Nature of Proposals
Row 0, Column 0Row 0, Column 1Row 0, Column 2Row 0, Column 3Row 0, Column 4
Row 1, Column 0Row 1, Column 1Row 1, Column 2Row 1, Column 3Row 1, Column 4
Row 2, Column 0Row 2, Column 1Row 2, Column 2Row 2, Column 3Row 2, Column 4
Row 3, Column 0Row 3, Column 1Row 3, Column 2Row 3, Column 3Row 3, Column 4
48
Key Compliance Reports If available
Drag and drop files here
Select files to upload
Cancelof
49
What do you see as the strengths of your business?
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50
Opportunities for growth / expansion?
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51
Any upcoming risks buyers should be aware of?
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52
Upload additional documents (optional)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
53
Declaration
I confirm the information provided is true and correct to the best of my knowledge.
54
Your Email AddressSo we can send you a confirmation of your submission
example@example.com
55
ABC Business Sales
56
Phone Number
Area Code
Phone Number
Should be Empty:

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