Information Request

Corporate name
DBA
Mailing address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Full legal name of the corporation
Valuation date
MM slash DD slash YYYY
Who referred you to us?*
Please specify
Your contact?
Purpose of the valuation
Please specify
Will the corporation resume operations after terminating the retirement plan?
- Yes
- No
Date the corporation was formed?
MM slash DD slash YYYY
Date the operations began?
MM slash DD slash YYYY
Date operations ceased?
MM slash DD slash YYYY
What date does your fiscal year end?
MM slash DD slash YYYY
Full legal name of any wholly or partially owned subsidiaries or dba's
Full legal name of retirement plan
Date the plan was formed
MM slash DD slash YYYY
Funding Information (prior to the valuation date)
List the exact dollar amounts and dates of each investment, and specify whether stock was issued for each investment.
401k plan
Personal
Other investments
Detailed description of the business and its operations
History
Ownership
Customers
Employees
Commentary on the prior year operations of the business (2019/2020)
Commentary and forecast on the next two years of operations (2021/2022)
Include the purpose of the additional funding
Reason for terminating the business?
What did you pay for the franchise fees and what are the terms?
Is the Franchise fee transferable or can it be sold to a third party?
Your estimated value of the business as of the valuation date?
If you do not have an estimate, you can leave this blank
Your website/social media information
List all remaining assets and their estimated market value as of the valuation date
(Including bank accounts, vehicles, furniture and equipment, inventory, etc.)
List all liabilities as of the valuation date
(This list should included both liabilities that will be paid, as well as liabilities not likely to be paid with an explanation of why).
List of all expenses that the business is expected to incur after the date of your most recent checking account statement that you provide for us
Administrative and accounting fees
Other
Total Fee Quantity
Price: $0.00
Provide the following documents and financial statements
(Send via email, PDF is preferred)
- Income statement and balance sheet
- Checking account statement:
- IRS federal tax filings:
- Stock Certificates, Stock Issuance Forms and/or Stock Ledger
- Prior valuations of your business

Information Request

Funding Information (prior to the valuation date)

Detailed description of the business and its operations

List of all expenses that the business is expected to incur after the date of your most recent checking account statement that you provide for us

Provide the following documents and financial statements