• Take Action
  • Home
  • /Buyer Registration

Buyer Registration

This form is also available for Download as PDF, which can be faxed to 260-485-4849.

General Information

Name

Corporate Name

Address

Address 2

Home

Mobile

Fax No.

Email

Why Do You Want to Buy a Business?

Background and Experience

Current Position:

Will You Be an Active Owner?:
YesNo

Absentee Owner?:
YesNo

Specific Business Request
Industry:
RetailManafacturingDistributionServiceOther

Preference

Rank:

1)

2)

3)

4)

5)

NAICS Classification code(s):

How Soon Do You Wish to Conclude A Business Acquisition?
Days
Months

Preferred Location of Business:
City
Miles Radius of City

Is Your Personal Financial Statement Updated?
YesNo If yes, Date of Statement

How Soon Can You Provide a Copy of the Financial Statement?:

Amount of Liquid Funds Available for Down Payment:
$**

When is the Down Payment Funds Available?:
**

Do You Have Assets with Equity to Leverage for Additional Financing if Necessary?:
YesNo

Real Estate:
$
Equity Value:
$
401K:
$
Stocks:
$
Other:
$
Amount of Annual Earnings Required:
$**
Return on Investment
%

If there are Partners/Investors, Their Names and Involvement are:

Name:

1)

2)

3)

Involvement:

Do You Need any Other Approval(s) to Make the Decision to Purchase?:
YesNo

If Yes, What is Their Name and Relationship?:

Name:

Relationship:

If a Bank is Involved, has a Contact Been Made?
YesNo

Name of Bank

Loan Officer:

Location of Bank:

Phone #:

Business Consultants

Attorney:

Accountant:

Firm:

Firm:

Note: ** Is a required field, and must be filled in to be accepted as a complete registration with AWBE