Business Planning Questionnaire

Planning Questionnaire

This information will help us to quickly hone in on where you are and what is important to you. It is strictly confidential and will not be shared with anyone but you (and your designated Advisor Team) for your planning. If you have any questions or would prefer a paper form to fill out, please contact Bill Black by email at BillBlack@ERSI.biz

Question Title

* 1. Please provide your:

Name

Date of Birth

Spouse's Name

Spouse's Date of Birth

Company Name

Company Street Address

City, State, Zip Code

Phone # (include area code)

Email address

Question Title

* 2. Owner Type

Individual

Individual + Spouse

Entity, ESOP or Trust

Question Title

* 3. Is your company a:

C Corporation

S Corporation

LLC

Other

If Other, Please Specify Company Type

Question Title

* 4. Company Information

State of organization

Year of Formation or Initial Operations

Describe the entity's industry or operations

Question Title

* 5. Please provide Owner Names, Percentage, and Relationship

You

Owner 2

Owner 3

Owner 4

Question Title

* 6. Company Real Estate: Do you

Own the Company's Building (individually or in an LLC)

Rent the Space

Question Title

* 7. With regards to your business property:

What is the square footage?

What amount of monthly rent do you pay?

(If owned by your LLC) What is fair market rent?

(If owned) What is the property fair market value?

(If owned) What is the amount owed on the building?

Question Title

* 8. If owned, what is the preferred future ownership of the real estate?

Retain the real estate

Sell the real estate

Unknown at this time/Negotiable

Year Purchased

Question Title

* 9. Is there a mortgage on the property?

Yes

Question Title

* 10. Personal Finances

Total Gross Personal Assets

Total Gross Personal Liabilities

Total Annual Non-Business Income

Question Title

* 11. Financial Performance

Average W-2 payroll of the company over the past 3 years

Average annual gross revenue of the company over the past 3 years

Average annual free cash flow of the company over the past 3 years

Question Title

* 12. Gross Revenues (estimate)

2016

2017

2018

2019 (projected)

Question Title

* 13. Pre-Tax Profits (estimate)

2016

2017

2018

2019 (projected)

Question Title

* 14. Owner Compensation (current full year)

Salary

Bonus

Perks

Question Title

* 15. Average time spent working for this company (Hours per Week)

Question Title

* 16. Does Owner have any personal responsibility or risk for business obligations and liabilities?

Personal Guarantee

Pledge of Security Interest in Personal Assets

Other (please specify)

Question Title

* 17. Does Owner have an Estate Plan?

Yes

Question Title

* 18. If Yes, When was Owner's estate plan last reviewed and updated?

It has not been reviewed/updated since creation.

Unknown

On a Certain Date:

Question Title

* 19. Does the Owner wish to make any of the following changes to his/her estate plan?

The personal representative

The trustee

The guardian

The ages of children at which they recieve part or all of their trust inheritance held in trust

Who is to own the business after the owner's death

Other (please specify)

Question Title

* 20. Is Owner interested in charitable giving upon any sale/transfer of the business?

Yes

Question Title

* 21. Most Recent Business Valuation (leave blank if none)

Year

Amount

Question Title

* 22. Business Active Children, Ages and Titles

Question Title

* 23. Children who are Not Actively Working in the Business, Ages

Question Title

* 24. Number of

Total Employees

Employees You Consider "Key"

Question Title

* 25. Names, Ages, Titles of "Key" Employees

Question Title

* 26. Do you have Employment Agreements with your "Key" Employees?

Yes

Question Title

* 27. Which Benefit Plans Do You Offer

Health Insurance

401k

Long Term Disability

Employee Life Insurance

Other (please specify)

Question Title

* 28. In order of preference, would you prefer to

Sell to Key Employee(s)

N/A

Sell to Child(ren)

N/A

Sell to All Employees (ESOP)

N/A

Sell to an Outside Buyer

N/A

Transition from Overtime to Part-Time and Hang on as long as possible

N/A

Question Title

* 29. Has the company been approached by any potential buyers?

Yes

Question Title

* 30. If yes, name of potential buyer(s) + Date

Potential Buyer 1 & Date Approached MM/DD/YYYY

Potential Buyer 2 & Date Approached MM/DD/YYYY

Potential Buyer 3 & Date Approached MM/DD/YYYY

Potential Buyer 4 & Date Approached MM/DD/YYYY

Question Title

* 31. What is the current level of review for the company's current financial statements?

Compiled

Reviewed

Audited

Question Title

* 32. Are the company's tangible and intangible assets protected from creditors, claims, liabilities, or misuse?

Yes

Question Title

* 33. Will the company experience any financial harm if any owner or employee is suddenly not available due to death or disability?

Yes

Question Title

* 34. If yes, is the risk adequately covered by the existing key person insurance?

Yes

Question Title

* 35. Does the company have any debt other than the typical operating liabilities?

Yes

Question Title

* 36. Is the company interested in recruiting new key employees?

Yes

Question Title

* 37. If yes, does the company have sufficient incentive plans in place to attract new key employees?

Yes

Question Title

* 38. Do you have written Business Continuity Instructions and an "Emergency Buyout Plan" in case you were to die suddenly?

Yes

Question Title

* 39. Do you have

Personal Life Insurance? (Specify Amount and type (Term or Permanent policy)

Company Owned Key Person Life Insurance? (Specify Amount and type (Term or Permanent policy)

A living Trust? (If so, when last reviewed)

A written plan to continue your salary to your spouse if you die suddenly?

Question Title

* 40. Who is on your Advisor Team? (Name + Firm is known)

CPA

Estate Planning Attorney

Business Attorney

Benefits Broker

Financial Planner

Valuation Specialist

Question Title

* 41. Please rank your planning priorities

Update or Create Business Valuation

N/A

Business Continuity Instructions and/or an Emergency Buyout plan in case I die Suddenly

N/A

Review, Update or Create my Living Trust and Family Estate plan

N/A

Key Employee Recruit, Reward & Retention Plan

N/A

Task Transition Plan for Me

N/A

Determine what amount I need to sell business for to sustain my lifestyle

N/A

Tax Minimization Strategies

N/A

Protect my Assets from Predators & Creditors (Asset Protection)

N/A

Management Team development

N/A

Grow the Value and Transferability of the Business

N/A

Establish Clear Goals

N/A

Treat Business Active & Inactive Children Fairly

N/A

Prepare the business for Sale to an Outside Buyer

N/A

Question Title

* 42. How much of his/her ownership does Owner want to transfer during his/her lifetime?

All

Some

None

Undecided

Question Title

* 43. If some, after the completion of any planned transfer, owner wants to retain what % of ownership interest in the company?

100

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 44. Does owner know target dates to start and complete the transfer? If no, leave blank

Start Date

End Date

Question Title

* 45. Is it important to buy out any co-owner prior to Owner's planned transfer?

Yes

Question Title

* 46. Upon death or disability, is there anyone who is capable and willing to manage the business?

Yes

Question Title

* 47. How would Owner prefer to continue upon death or disability?

Transfer to family member

Sell to Co-owner(s)

Sell to key employee(s)

Sell to outside third party

Hold in trust

Liquidate

Other (please specify)

Question Title

* 48. Please identify persons capable of running the business and potential successors

Question Title

* 49. Do any of the potential successors need assistance in developing their ownership skills?

Yes

Question Title

* 50. Is the owner's intention to work for the company indefinitely?

Yes

Question Title

* 51. If yes, does the owner want the ability to leave for extended periods of time?

Yes

Question Title

* 52. If no, what is the owner's intended departure date?

Date MM/DD/YYYY

Date