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Buyer Pre-Qualifier Form
INFORMATION TO BE KEPT CONFIDENTIAL AND USED FOR NO OTHER PURPOSE-THE MORE DETAIL THE BETTER SO PLEASE TAKE YOUR TIME
To set a meeting with a broker and/or seller, seller requires to have some background on you and/or your company to provide additional information or time.
First Name
*
Last Name
*
Your Personal LinkedIn URL:
*
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Phone Number
*
Email Address
*
What business/s did you contact us about?
Please give description of the listing of interest.
*
If this business does work out to be of interest, what verticals might you be interested in?
*
If you have owned a business before please provide information about that venture.
*
The reason I am interested in buying a business:
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Work/Own a Business
Investment
Increase my income
To Expand my Current Business
Other
The reason I want to buy a business at this time:
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I sold my business
I am selling my business
I got laid off
It's my life's dream
I just received some cash
Other
Have you been convicted of a felony?
*
Yes
No
Amount of free cash flow desired?
*
$50-$150K
$150-$350K
$300-$500K
$500-$750K
$750-$1M
Over $1M
What is your background and current employment?
*
Annual income needed?
*
What is your current salary or compensation?
*
You must have at least one item.
$50,000-$100,000
$100,000-$250,000
$250,000-$500,000
Over $500,000
What is your approximate age?
*
You must have at least one item.
20-30
31-40
41-50
51-60
Over 60
Have you ever had a judgement against you?
*
Yes
No
Have you ever declared personal bankruptcy?
*
Yes
No
If you have a retirement plan of any kind would you be interested in broker making an introduction so that you may use some or all of these funds to buy business?
*
Yes
No
Are you interested in working in the business day-to-day or hire General manager or Promoter within?
*
I will run
Hire GM
Promote within
When are you planning to buy a business?
*
Now
3-6 mo.
Over 6 mo.
How long have you been looking for a business?
*
Now
1 mo.
3 mo.
6 mo.
Over 6 mo.
Who will help you run the business?
*
No one
Partner
Friend
Relative
Spouse
Children
How will you finance your total investment?
*
Cash
Bank Loan
SBA Loan
Private Investor
Family
Have you pre-qualified with a bank?
*
Yes
No
My FICO score is approximately?
*
If you are planning to use a SBA or Conventional Loan would you like broker to make introduction to a banker that is familiar with the business your are interested in?
*
Yes
No
If you have been pre-qualified by a bank you can send qualifier letter from bank to dan@rvabusinessbrokers.com
*
Yes
No
Estimated Personal Financial Statement
(Strictly Confidential)
Assets
*
Your Response:
Available Cash
Your Response:
Real Estate Value
Your Response:
IRA & 401K
Your Response:
Other Assets
Your Response:
Total Assets
Your Response:
Liabilities
*
Your Response:
Notes Payables
Your Response:
Credit Card Balances
Your Response:
Real estate Mortgages
Your Response:
Other Liabilities
Your Response:
Total Liabilities
Your Response:
Please articulate more about why this listing may be a good fit for you? Describe any skill sets you or your partner bring to the table. The more information you can supply here the better plus email if you have it your resume to dan@rvabusinessbrokers.com
*
What would you like as the next step in this process to be before you submit your qualifications?
*
Broker to upload confidential data such as tax returns, financials etc for further diligence.
Schedule a meeting with broker. Click schedule link below
Schedule a call with broker and seller. Click schedule link below
An incognito site visit.
!!! BE SURE YOU GO TO THE BOTTOM AND CLICK SUBMIT !!!
Your Signature:
*
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