Corporate Buyer Registration Form

Officer Name *

Title *

Corporate Name *

Address *

Phone *

Email *

Preference

Rank:

1)
2)
3)
4)
5)

NAICS Classification code(s):

1)
2)
3)
4)
5)

Preferred Location of Business

Amount of Funds to be Committed

What is the Acquisition Timing?

Optimum Revenue of Target Company

Amount of Pre-Tax Earnings EBITDA

$

Annual, Return on Investment

If there are Partners/Investors, Their Names and Involvement are:

Name:

1)
2)
3)

Involvement:

1)
2)
3)

Do You Need any Other Approval(s) to Make the Decision to Purchase?

Yes

No

What is Their Name and Relationship?

Name
Relationship

If a Bank is Involved, has a Contact Been Made?

Yes

No

Name of Bank

Loan Officer

Location of Bank

Phone Number

Signature of Corporate Representative

Clear

Authorized Officer

© Copyright 2024. Anthony Wayne Business Exchange. All rights reserved.

CONTACT

Anthony Wayne Business Exchange

3508 Stellhorn Rd.

Fort Wayne, IN 46815

Voice: 260-485-1990 (Fort Wayne Office)

2176 N. Biomet Drive Ste 3

Warsaw, IN 46582

574-269-1407 (Warsaw Office)

Email: den@anthonywayne.com

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