Please Copy and Paste This Into MS Word or Other to Fill Out

POTENTIAL BUYER'S PERSONAL PROFILE
 CONFIDENTIAL INFORMATION

WE NEED THE FOLLOWING CONFIDENTIAL FACTS ABOUT YOU PRIOR TO RELEASING ANY INFORMATION

PLEASE TYPE THIS OUT IN WORD OR PRINT CLEARLY IN BLOCK LETTERS

Date: ________ Full Name: ____________________________    Title: __________
Company (if applicable): _____________________________   DUNNS #:__________  
Address: __________________________________
City: ____________________State: _____ Zip: _______
Home #:____________ Cell: __________ Work: ­__________   Fax: __________   Email: _______________________________                              

Present Occupation or Business: ________
Background, Experience, Skills: _________

You will operate the business: Full time □ Part time □   Absentee □    With Partner □   With Family □
                                                                                                                     
How much cash is available for a down payment and working capital? $ __________

When will it be available? ­__________

Do you have financial partners providing these funds?     Yes □    No □ 
If yes, do you have a written agreement?                     Yes □    No □

Name of financial partners (if applicable): Full Name: _______________________
Business Name: _________________________
City: ____________________State: _____ Zip: _______
Home #:____________ Cell: __________ Work: ­__________   Fax: __________   

When do you want to take possession if the sale goes through? :_____________
     
What is your personal or business estimated Net Worth? :_____________    
 
Who besides yourself will be involved in the decision? :_____________
  
Remarks or special needs::_____________

I certify that the above information is true and correct, agree to the terms and acknowledge receipt of a copy of this profile. The Seller requests that a Non-Disclosure Agreement , Confidentiality Agreement and evidence of you, the potential Buyer (s), financial ability to purchase before disclosing any information of the name and location of the business to be disclosed to you. The information you are to receive is to be kept strictly confidential regarding the business given to you, but not limited to the following: Financial information, ownership, documents, records, photographs and any repositories or representations of such information, hereinafter referred to as confidential information.

Print Full Name: ____________________________________   Signature: _____________                                         Date: ___________

This form must be sent with the Non-Disclosure and Confidentiality Agreement Form

Please Print It after Filling it Out, Sign & Date It, then Fax Back this completed & signed agreement to 866-440-4279