Description or ID # Of
Business You are Inquiring About?
You're Current Occupation:
You're Past Occupation &
Brief Business Experience or History:
Time Frame To Buy A Business?
Please choose
ASAP
Next 30 days
Next 3 months
Next 3 to 6 months
Next 6 to 12 months
Over 12 months
Liquid Capital Available To
Invest?
Please choose
Less than $10,000
$10,000 to $15,000
$15,000 to $20,000
$20,000 to $30,000
$30,000 to $40,000
$40,000 to $50,000
$50,000 to $60,000
$60,000 to $75,000
$75,000 to $100,000
$100,000 to $125,000
$125,000 to $150,000
$150,000 to $200,000
$200,000 to $250,000
$250,000 to $350,000
$350,000 to $500,000
$500,000 to $750,000
$750,000 to $1,000,000
$1,000,000 +
Your Approximate Net Worth?
Please choose
Less than $25,000
$25,000 to $50,000
$50,000 to $75,000
$75,000 to $100,000
$100,000 to $125,000
$125,000 to $150,000
$150,000 to $175,000
$175,000 to $200,000
$200,000 to $250,000
$250,000 to $300,000
$300,000 to $350,000
$350,000 to $400,000
$400,000 to $500,000
$500,000 to $600,000
$600,000 to $750,000
$750,000 to $1,000,000
$1,000,0000 +
Will You Be Seeking Financing To
Buy A Business?
Please choose
Yes
No
Not Sure
SBA Financing
Additional Comments You would
Like To Share With Seller
