Businss Valuation input form

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Please enter as much information as possible. The old saying "Garbage in, Garbage out" applies.

If you are not sure about items put in a question mark. We recommend that you ask your CPA for entry help if in doubt.

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* 1. What is your

Name

Company Name

Your Title

Phone Number

Email address

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* 2. What is your Company Operating as?

C Corporation

S Corporation

LLC

LLP

Partnership

Sole Proprietorship

Other (please specify)

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* 3. When is your fiscal year end? (MM/DD)

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* 4. In what year did your business start?

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* 5. What is your projected Growth rate next year (%)?

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* 6. What do you project your long-term average profit margin to be (%)?

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* 7. What percentage of your business is recurring business (5)?

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* 8. What percentage of your sales are done with your top 3 customers (%)?

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* 9. What percentage of your sales are done online (%)?

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* 10. What would be the impact on your sales and revenues if the Owner left the business suddenly?

Remain the Same

Decline Slightly

Decline Moderately

Fall Substantially

Plummet

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* 11. How many:

Total Employees

"Key" Employees

Active Owners

Inactive Owners

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* 12. What is your

Insustry Classification (written)

Business Activity Code Number (from top of Tax Return)

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* 13. Do you own any Intellectual Property Rights (Trademarks, Patents, etc)?

Yes

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* 14. With Regards to Business Property

Owned by Owner and in an LLC

Owned by Owner outright

Rent

It's complicated - let's discuss

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* 15. Business Real Estate

Square Footage

Rent paid

Estimated Fair Market Value of Rent

Building Value

Mortgage Remaining

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* 16. Financial Data for 2013 - from P&L

Revenue

Pre-Tax Income

Officer Compensation (see below)

Interest Expense

Non-Cash Expenses

One-time Expenses

One-time Revenue

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* 17. Financial Data for 2013 - From Balance Sheet

Cash

Accounts receivable

Inventory

Other Current Assets

Fixed Assets

Intangible Assets

Accounts Payable

Other Short-Term Liabilities

Bank Loans

Other Long-Term Liabilities

Contingent Liabilities

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* 18. Financial Data for 2014 - from P&L

Revenue

Pre-Tax Income

Officer Compensation (see below)

Interest Expense

Non-Cash Expenses

One-time Expenses

One-time Revenue

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* 19. Financial Data for 2014 - From Balance Sheet

Cash

Accounts receivable

Inventory

Other Current Assets

Fixed Assets

Intangible Assets

Accounts Payable

Other Short-Term Liabilities

Bank Loans

Other Long-Term Liabilities

Contingent Liabilities

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* 20. Financial Data for 2015 - from P&L

Revenue

Pre-Tax Income

Officer Compensation (see below)

Interest Expense

Non-Cash Expenses

One-time Expenses

One-time Revenue

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* 21. Financial Data for 2015 - From Balance Sheet

Cash

Accounts receivable

Inventory

Other Current Assets

Fixed Assets

Intangible Assets

Accounts Payable

Other Short-Term Liabilities

Bank Loans

Other Long-Term Liabilities

Contingent Liabilities

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* 22. Projected Financial Data for 2016 - from P&L

Revenue

Pre-Tax Income

Officer Compensation (see below)

Interest Expense

Non-Cash Expenses

One-time Expenses

One-time Revenue

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* 23. Projected Financial Data for 2016 - From Balance Sheet

Cash

Accounts receivable

Inventory

Other Current Assets

Fixed Assets

Intangible Assets

Accounts Payable

Other Short-Term Liabilities

Bank Loans

Other Long-Term Liabilities

Contingent Liabilities