Name:

Address

City    State ZIP

Biz Phone:   Email  

Home Phone: FAX

Background Information:
Education:  College(s) Degree(s)
Business experience: (Check all that apply)
Sales Manufacturing Accounting Retail Engineering Finance Service Marketing Distribution Operations Other
Industries experienced
Positions held
Do you own any businesses presently? Yes    No 

If yes, what type(s) of business(es)?

Approximate total annual revenues(s):

Is this your first acquisition for your own portfolio?

Are you interested in acquiring less than 100% ownership?

Will you be an: Active Manager Passive Investor

How long have you been seeking an acquisition?
How soon is acquisition desired?

Are you the sole buyer/investor? If no, how many others?

Willing to Relocate?

Criteria: Size of Business Envisioned

Revenue Range: $ to

Transaction Value: $ to

Minimum Pre-Tax: $

Minimum Cash Flow: $

Please provide any additional comments related to your acquisition needs or strategy that would give added insight in selecting acquisition candidates for your consideration including hobbies and special interest.

Specific Skills/Knowledge

We all have more skill, knowledge and comfort in some areas as compared to others.  Listed below are specific areas where you can rate your level of skill and comfort on a scale of 1 - 10 (10 being the highest level of skill, knowledge or comfort).

Accounting  Finance Taxes Selling Marketing Sales Management Managerial Motivational Ability Analytical Verbal Writing Mechanical Design Computer Operation Computer Programming Systems/Controls Concepts Manual Dexterity Public Relations Teaching Artistic Scientific Clerical  Math Music Friendliness Office Skills Public Speaking  Supervise Others Work w Children Fix Things  Influence Others Record Keeping Planning  Other

Occupations and Business Daydreams

List below the businesses and careers you have daydreamed about as well as those you have discussed with others.  Put your first choice first and work backwards to other jobs or businesses you have considered.

Lifestyle and Financial Requirements:

Time distance of business from home
Number of days per week you are willing to work

Earliest starting time desired Latest quitting time

Minimum amount of compensation (start) required  $ per month

Is the ability for family members to participate important

Prefer work environment to be inside, outside, both or doesn't matter

Prefer business to address hobbies or special interests

Aversion to specific products, services or industries.  If yes explain

The size of the business that would be right for you should be in balance with the amount of equity you would be comfortable investing.  The capital available for Down Payment:  Cash Equity in Real Estate Marketable Securities Family, friends, etc.

Total Available for Down Payment $

Preferred price of business from to

Preferred initial investment from  to

Thank you for taking the time to complete this worksheet and hope it has helped you.  Should you wish to discuss engaging us to direct a Business Search for you simply indicate below and submit the form to us.   We will review and contact you for discussion of your options.

Please contact me to discuss your searching for a business on my behalf    

            Comments: