Confidential Purchaser Profile
Sunbelt Business Brokers of Northwest Florida

Name:       _______________________________                 Daytime Phone: _______________
Address:  ____________________________                         How long at this address: _______
                  ____________________________                        Own your home?           Yes   /   No
                  ____________________________                        Marital Status:  _______________
Email Address:  _________________________________________

The following questions must be answered in order for Sunbelt Business Brokers to divulge confidential information about any business.

1. What is your current occupation? _______________________________________________

2. Have you owned a small business before?  Yes ___            No ___
If yes, what kind? _________________            _______________________________________    

3. Have you managed a business for another?  Yes ___       No ___  
If yes, what? ____________________________________________________________  

4. Will you run a business you purchase yourself or will it be family-run or run by a manager?                                                        Self ___     Family ___   Manager ___

5. Will you seek owner financing, bank financing or pay cash for a business?
                                                        Owner _____   Bank _____   Cash  _____

6. Is there a specific business or type of business you are most interested in owning?
            Yes ____      No ____ . If yes, what kind? _____________________________________

7. How much of your liquid capital do you feel comfortable allocating to a business purchase?
(Note: This does not mean capital tied up in real estate or that you will seek from another.)                                                                             $_____________________                               

8. Will you need to borrow money from a friend, relative or investor to do this transaction?
                                                                                                                         Yes ___        No ___  
ASSETS

Cash $__________________                   Bank: ______________________________________
Stocks $_________________                  Type:  ______________________________________
Securities $______________                   Type:  ______________________________________
Value of Real Estate $_____________    Balance Owed $ ______________Type: _______________
Other $_________________                    Type:  ______________________________________

I warrant the above information to be true and correct and authorize Sunbelt to verify said information. I understand that to receive confidential information about any business offered by Sunbelt Business Brokers of N.W. FL that I must show financial ability to complete a transaction of the price range and cash requirements deemed to be necessary by Sunbelt and the seller for that business. It is understood that misrepresentation as to my financial status will be grounds for forfeit of my deposit on any transaction entered into involving Sunbelt Business Brokers of N.W. FL.

Signature: ________________________________                    Date: ________________
Return fax number: 850-650-4683