New Client Summary

Please provide the following information:

1. First Name

Last Name

2. Company Name & DBA

3. Confidential Mailing Address

4. City

5. State

6. ZIP Code

7. Web Site (must include: https://www. )

8. Mobile Phone

9. Confidential Phone Number

10. Spouse

11. Special Instructions

12. Best Time To Call

13. E-mail

14. The Company specializes in providing the following:

14a (Continued)

15. Type of Business

16. Year Established

17. Acquired or Started

18. Type of Corporation

19. Area of Operation

20. Hours of Operation

21. Transition Time

22. Reason for Selling

23. Shareholder 1

24. Percentage

25. Title for Shareholder 1

26. Shareholder 2

27. Percentage 2

28. Title for Shareholder 2

29. Shareholder 3

30. Percentage 3

31. Title for Shareholder 3

32. Shareholder 4

33. Percentage 4

34. Title for Shareholder 4

35. Market 1

36. Percent of Market 1

37. Market 2

38. Percent of Market 2

39. Market 3

40. Percent of Market 3

41. Market 4

42. Percent of market 4

43. Certifications 1

44. Certification 2

45. Certification 3

46. Top 1 of 5 Products of Services

47. Top 2 of 5 Products or Services

48. Top 3 of 5 Products of Services

49. Top 4 of 5 Product of Services

50. Top 5 of 5 Product or Services

51. Cash or Accrual

52. Value of Personal Vehicles

53. Revenue Next 12 months

54. Fiscal Year

55. Customer Terms

56. Healthcare Provider

57. Union or Nonunion

58. Number of Employees

59. Number of Hourly

60. Rate Range

61. Number of Salaries

62. Range

63. Payroll Weekly or Bi-weekly

64. Key Personnel 1

65. Position 1

66. Duties 1

67. Key Personnel 2

68. Position 2

69. Duties 2

70. Key Personnel 3

71. Position 3

72. Duties 3

73. Key Personnel 4

74. Position 4

75. Duties 4

76. Advertising Overview

77. Own or Lease

78. FMV of Building & Land

79. Monthly Rate

80. Lease Terms

81. Number of Buildings

82. Square Footage

83. Total Square Footage of Office Space

84. Total Square Footage of Storage & Production Area

85. Zoning

Referred By IAG or Integrated Advisory Group

WEBID Number

Assignment & Special Instructions

Salesperson

Book Fee