Pre-Qualification Questionnaire

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Pre-Qualification Questionnaire

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Pre-Qualification Questionnaire

Personal Information

* Indicates required field

Select One *

Business Broker Business Owner

First Name *

Last Name *

Email *

Phone Number *

Paste Your LinkedIn Profile Here *

i.e. https://www.linkedin.com/in/dr-henry-silvestriz/

Business Information

Full Business Legal Name *

Street Address & City *

Year it was established *

U.S. States & Territories *

Select One

Business Type/Industry *

Country *

Company Website *

Annual Revenue in USD *

Select one

Is the business structured into a company? *

Yes No

Employee Identification Number (EIN) *

Business Description *

Can you provide the last 3 years P&L and the Monthly balance sheets? *

Yes No

Select one

Is your business currently profitable? *

Yes No

Select one

Why are you interested in selling? *

Please be thorough.

Is the seller interested in retiring? *

Yes No

Select one

Is the seller looking to move on to the next venture once he or she resigns? *

Yes No

Select one

How motivated is the seller to resign from his / her position? *

Is the business cash flow positive? *

Yes No

Select one

What is the total net asset equity (value less financing)? *

Total secured debts (including encumbered assets / real estate)? *

Total unsecured debts (including credit cards / loans / overdraft / etc.)? *

Does the business own its real estate? *

If so, does its real estate have a mortgage ,if so what is the equity? *

What is the total value of the outstanding receivables in USD? *

Please select one

What is the monthly burn rate of the company? (Cost of goods sold to break even) *

How long has the business had a relationship with the bank? What bank? *

What is the current relationship like with the company’s bank? *

How many regular clients does the company have? *

What is the Number of Employees? *

How many are full-time employees? *

How many are part-time employees? *

How many are contractors? *

What is the total value of the inventory in USD? *

Enter inventory total value here in USD

What is the business overdraft limit in USD? *

How is the current relationship with the companies bank? *

Bank account balance as of today? *

What is the typical order value from a client? *

Are all tax affairs up to date? *

Yes No

Select one

If not please explain why *

What is the total value of the companies tangible assets? *

Select one

What portion of the companies assets are encumbered? *

What are the current unsecured credit limits / balances? *

Enter limits / balances

What is the total undrawn credit card limits? *

Amount due to payables (Supplier invoices pending payment)? *

Please select one

What is the total book value of the stock / inventory held in USD? *

Please select one

What is the typical working capital required to sustain daily operations (USD)? *

Enter amount in USD

Has the company and or its directors ever been subject to any legal or insolvency proceedings? *

Yes No

Are there any outstanding legal cases? *

Yes No

Select one

If yes, please explain *

What % of the monthly revenue equates to sales and marketing? *

Sale and marketing % for monthly revenue

What % of the monthly revenue is delegated to the company’s growth? *

Does any relatives of the shareholder / owner work for the company? *

Yes No

Select one

If yes, what is the relative(s) position in the company? *

How many days on average do customers take to pay invoices? *

Average days

How many days on average do suppliers get paid? *

Average days

Does the EBITDA include the directors salary? *

Yes No

Select one

How much is the directors salary? *

Does the EBITDA include directors / shareholders salary & dividends? *

If yes, please provide an adjusted EBITDA excluding this figure. *

Total dollar amount the director / shareholders received in the last 12 months? *

What has been taken into account to calculate the EBITDA? *

What is the role of the owner / majority share holder? *

How many share holders are in the company? *

What is the current credit score of the company? *

Does the business hold any Intellectual Property (IP)/Patent? *

Yes No

Is there any Patent Pending? *

Yes No

Submit

RULE NUMBER ONE

RELAX,

you can rest assured

that we will take care of your legacy.

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Pre-Qualification Questionnaire

Disclosure

Pre-Qualification Questionnaire

Personal Information

Business Information

RULE NUMBER ONE

RELAX,

​you can rest assured

​that we will take care of your legacy.

you can rest assured

that we will take care of your legacy.