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Company Profile
Company Name:
Address:
City:
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Zip:
Province:
Postal Code:
Country:
Telephone:
Fax:
Email:
Type of Business:
Date Established:
Type of Entity:
Corporation
Partnership
Sole Proprietorship
# of Shareholders:
# of Employees:
# after Public Offering:
Purpose of Going Public:
Aquisitions
Capital
Do you have acquisition targets?:
Yes (number
)
No
Amount of Capital Needed: $
When Capital is Needed:
Bank Contact:
Telephone:
Accountant:
Telephone:
Attorney:
Telephone:
Trade Reference:
Telephone:
CORPORATE CHARACTERISTICS AND OWNERSHIP
State of Inc:
SIC Code:
Date of Inc.:
Authorized Shares in Common:
Par Value:
# Common Shares Outstanding:
Par Value:
# of Preferred Shares Outstanding:
Par Value:
# of Preferred Shareholders:
Average Gross Revenue YTD:
Average Profit in %:
LIST BELOW ALL OFFICERS, DIRECTORS, PARTNERS, OWNERS, CO-OWNERS, AND ALL STOCKHOLDERS WITH 20% OR MORE OF TOTAL STOCK ISSUED.
Name:
Title:
Own:
% Compensation:
Name:
Title:
Own:
% Compensation:
Name:
Title:
Own:
% Compensation:
ESTIMATED USE OF PROCEEDS
Salaries and Fees: $
New Bldg. Construction: $
Real Estate Purchases: $
Bldg. Improvements/Repairs: $
Machinery and Equipment: $
Inventory Purchases: $
Acquisition of Existing Business: $
Paying Loans: $
Paying Bank Loans: $
Other Debt Payment: $
Working Capital: $
TOTAL ESTIMATED AMOUNT: $
MINUS EXISTING FUNDS: $
TOTAL USE OF PROCEEDS: $
BUSINESS PROFILE
Nature of the Business:
Type of Product/Services:
Significant Competitors:
Sales Forecasts, next 3 years, by year:
Customer Profile:
List of Key Customers:
Major Past Accomplishments:
Recent significant events (lawsuits, spin-offs, acquisitons):
Future Plans for Growth/Expansion:
How IPO will benefit the company?
What new job opportunities will IPO Create?:
Comments: