Sell My Business Registration Form

In order to best serve your needs, please complete this form and one of our team members will be in touch with you. Your information will be held in the strictest confidence and there is no obligation.

  • Assets

    Omit Cents
  • Liabilities

    Omit Cents
  • Section 1. Source of Income

  • Contingent Liabilities

  • Note: Alimony or child support payments do not need to be disclosed in "Other Income" unless it is desired to have such payments counted toward total income.
  • Section 2. Loans payable to banks and others

    Use attachments if necessary. Each attachment must be identified as a part of this statement and signed.
  • Upload a document with the following:
    • Name and address of noteholder(s)
    • Original balance
    • Current balance
    • Payment amount
    • Frequency (monthly, etc)
    • How secured or endorsed type of collateral or applicable
  • Accepted file types: doc, pdf.
  • Section 3. Stocks and Bonds

  • Upload a document with the following:
    • Number of shares
    • Name of securities
    • Cost
    • Market value quotation/exchange
    • Date of quotation/exchange
    • Total value
  • Accepted file types: doc, pdf.
  • Section 4. Real estate owned

    List each parcel separately. Use attachment if necessary. Each attachment must be identified as a part of this statement and signed.
  • Upload a document with the following:
    • Type of property
    • Address
    • Date purchased
    • Original Cost
    • Present market value
    • Name of mortgage holder
    • Mortgage balance
    • Amount of payment per month/year
    • Status of mortgage
  • Accepted file types: doc, pdf.
  • Section 5. Other personal property and other assets

  • Section 6. Unpaid taxes

  • Section 7. Other liabilities

  • Section 8. Life insurance held

  • I hereby affirm that this personal financial statement contains no willful misrepresentation or falsifications and this information given by me/us is true and complete to the best of my/our knowledge and belief.
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