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Business Fact Finder

Fill out this form so that we can get to know you and your business better. We work with small and medium sized commercial businesses on a daily basis. We hope we can become your partner and help you with reaching your business goals.

Business Information:

Once you’ve completed this assessment, our advisor will reach out to you to discuss ways we can assist you in reaching your goals.

Business Name:

Primary Contact:

Industry:

Phone:

Email:

Address:

City:

State:

Zip:

Number of Years in Business:

Website:

Total Number of Employees:

Part-Time Employees:

Number of Key Employees:

Business Organization

Organization Type:

Sole Proprietorship
General Partnership
LLC
Professional Service Association or Corporation
Non-Profit
Subchapter C-Corporation, subject to corporate income tax at a marginal tax rate of %
Subchapter S-Corporation

Subchapter C-Corporation Marginal Tax Rate

End of Fiscal Year:

Fiscal Year:

Cash
Accrual Basis

Professional Advisors:

Accountant Name:

Address:

Phone:

Email:

Attorney Name:

Address:

Phone:

Email:

Owners/Key Employees

Names	Ages/DOB	Ownership%	Personal Tax Bracket %	Total Annual Compensation $	% of Debt Attributable	% of Profits Attributable

Are any of the owners related?

If yes, name(s) and relationship(s):

As a business owner, I'm concerned about (check all that apply):

Business Protection:

Leaving business debts that my family has to pay
Revenue loss in the event a key person unexpectedly passes away
Having capital to recruit and train a replacement
Employee's perception of the financial stability of the company should a key person unexpectedly pass away

Recruiting, rewarding, and retaining top talent

Attracting New Talent
Providing benefits with tax-deductible dollars
Losing key talent to competitors

Planning for business succession

Being able to efficiently transfer my business ownership interest
Protecting my family's income in the event of my death
Assuring business continuity
Equitable distribution of assets to my children who aren't involved in the business

Benefits Information (check those currently in place):

Qualified pension/profit sharing/IRA/SEP
Deferred compensation
Split-dollar plan
Executive bonus
Supplemental disability income insurance
Long-term care insurance
Group insurance (life, health, dental, disability)

Describe any existing corporate-owned life insurance (COLI) and the reason for coverage.

How important is each of the following considerations?

Create a fringe benefit for the owner(s)

Not Important
Important
Very Important

Provide executives with incentives to stay with the business

Not Important
Important
Very Important

Allow executives to defer compensation

Not Important
Important
Very Important

Create an asset owned and controlled by the business

Not Important
Important
Very Important

Recover the cost of providing the benefit

Not Important
Important
Very Important

Provide life insurance coverage until retirement

Not Important
Important
Very Important

Provide life insurance coverage beyond retirement

Not Important
Important
Very Important

Are you interested in an informal Business Valuation?

Book value information:

Assets: $

Asset Adjustments: $

Liabilities: $

Liability Adjustments: $

Valuation method information:

Earnings are:

Stable
Variable
Volatile

Rate of return on assets:

Projected growth rate of earnings: (Year-over-year growth on earnings)

Number of years to apply growth rate on earnings: (10 years is typical for a mature business)

Long-term growth rate: (Typical long-term growth ranges from 2.5-3%)

Number of years to include goodwill:

You can upload any files here

Name

Additional Resources

Additional Resources

Additional Resources

Additional Resources

Business Fact Finder

Business Fact Finder