Prospective Valuation Client Questionnaire

BCC ADVISERS would be pleased to prepare a proposal to value your business entity. Simply complete the form below and click the "SUBMIT" button found at the end of the form. In order to provide our best proposal, BCC ADVISERS needs to review the past 3 years of financial statements of the entity to be appraised. Your financial statements will be kept completely confidential! You can send your financial statements to BCC ADVISERS. Please give Al Ryerson, Greg Weber, or Jim Nalley a call at 1-866-787-8019 to discuss your valuation needs in complete confidence and to review how to proceed.

Once we have received all the necessary information, a proposal will be sent to you via your choice of first class mail, fax, e-mail or overnight delivery. If you have any questions regarding this form, please e-mail them to Al, Greg, or Jim.

Questionnaire Form

Please provide the requested information as completely as possible to facilitate our preparation of a comprehensive proposal in a timely fashion. Indicates a required field.

Client Name:
Entity to be Valued:	Full legal name of the entity to be valued
Type of Entity:	C Corporation Limited Partnership S Corporation Limited Liability Company General Partnership Sole Proprietorship
State of Organization or Incorporation:
Date of Formation:
Principal Business Location:	City, State
Business Interest to be Valued:
Description of Business:
Current Annual Revenues:
Current Annual Net Income:
Book Value:
Recent Earnings Growth:
Purpose and Intended Use of the Appraisal:	Possible purchase/sale of business Gift tax purposes Estate tax purposes Employee Stock Ownership Plan (ESOP) Intra-family sale transaction Charitable gift Buy-Sell agreement &Marital dissolution Other
Effective Date of Appraisal:	For example, date of death or alternate valuation date for estate, gifting date, or other transaction date.  To be determined
Known Deadlines or Desired Timetable:	If there is a known deadline (e.g., an estate tax filing date) please indicate.
Other Comments or Questions:
Name:
Company:
Address:
City:
State:
Zip Code:
Phone:
Fax:
Email: