If
you have a business available for acquisition, this information will allow
us to evaluate whether your company meets our clients' criteria.
Please understand that all information provided will be held in the
strictest of confidentiality. If you would prefer to have a
confidentiality agreement executed prior to completing this form please click
here and fax the signed agreement to 301-458-0884,
we will then return a copy for your records.
(Required fields indicated with *.)
Company
Name*
Title
Address
City
State
Zip Code
Country
Office
Phone
Ext.
Mobile
Phone
Contact Preference
For
confidentiality purposes, please
select your contact preference.
Home
Phone
Fax
Email
(1)*
Email
(2)
Website
Business
Type* Please
note that more than one type can be
selected by holding down Ctrl.
Business
Location(s)*
Financial
Information
2005*
2004
2003
2002
Cash Flow /
EBITDA
$
$
$
$
Revenue
$
$
$
$
General Information
Year
Established*
Number
of Employees*
Reason
for Selling
Business Description* Please describe the business and provide any information that might be
helpful for a potential
buyer. Applicable information may include descriptions
of the business facilities, market
competition, opportunities for growth and expansion, and
support/training that will be provided,
and possible financing. You may also send
additional documentation by email
to info@burleyonline.com
or by fax to (301) 840-3864 as appropriate.
Other Remarks
Would you like to
learn more about
how we can assist you in the acquisition process?
