By signing below the prospective Buyer acknowledges reading and understanding the disclosures stated above. Receipt of a copy and acceptance of the terms of this acknowledgement and agreement is hereby acknowledged and confirmed.
Name: Address: Email: Phone: Cell:
IN WITNESS WHEREOF the Parties have executed this Agreement and have the authority to bind their respective companies.
Executed at :
Personal Financial Statement
Name: Phone: Residence Address: Date:
Assets
Cash on hand & in Banks: Savings Accounts: IRA or Other Retirement: Accounts/Notes Receivable: Stocks, Bond, Mutual Funds: Life Insurance (Cash Value): Real Estate: Automobiles: Other Personal Property: Other Assets: Total Assets:
Liabilities
Accounts Payable: Notes Payable to Banks: Notes Payable to Others: Notes Payable on Autos: Loan on Life Insurance: Mortgages on Real Estate: Unpaid Taxes: Other Liabilities: Total Liabilities:
Net Worth:
Current Employer: Approximate Annual Salary:
Confidential Buyer Profile
Credit score:
Current or most recent business ownership:
How many years experience:
Do you hold any applicable Licenses:
Will you have assistance in business operation (ie. family or partner):
I intend to seek financing for the purchase through the following:
Please specify details about your above selection:
I hereby declare, that to the best of my knowledge, the above information is true and accurate.
Please note that this information will be held in the strictest confidence and only be used to evaluate the individual as a potential purchaser of a business.
Engagements Interest: Engagements URL: Engagements ID: Engagements Price: Engagements Agent:
Date:
