Noteholder name

Telephone

Fax

Date

Email

How did you find Beneficial Brokers, LLC?   Please Select Business Associate Friend Internet Search Word of Mouth Other

Business Information:

Type of business 

How long in business?    Years   Months
 
Asset value breakdown:  

Equipment $

Inventory $

Goodwill $

Is your operation a franchise?  Yes   No

Is your note personally guaranteed?  Yes   No

Is your business location leased?  Yes   No 

Street address of your business 

City

State

Zip 

Note Information:

Selling price of your business $

Down payment $

Original note balance $

Months financed

Interest rate % on note

Date of first payment 

Monthly payment $

Number of payments remaining 

Balloon payment?  Yes   No

Current note balance $

Credit of payer:

Excellent     Good     Marginal     Bad     Unknown

   

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