Buyer Registration Form
ONLY FILL IN APPLICABLE INFORMATION: CORPORATE or INDIVIDUAL
PERSONAL/CORPORATE INFORMATION
Date
How Did You Find Us?
Company Name
Office Phone
Contact Name
Office Fax
Address
Office Email
City, Prov/State
Web Address
Country
Cell Phone
Postal Code/Zip
Home Phone
PROFESSIONAL INFORMATION
Education or Professional Accreditations
Employment Positions Held
Other
Companies Owned (Type)
Products or Services Offered
FINANCIAL INFORMATION
Investment Level (acquisition range)
$
Cash Available To Invest (before financing)
$
Other Equity Available (how much – from where)
$
Verification Available To Purchase(Financial statement of accountant/banker contact)(Public Company – Provide Latest Annual Report)
INDUSTRY/AREA PREFERENCES
Distribution :
Describe In Detail:
Manufacturing
Retail
Service
Wholesale
LOCATION PREFERENCES
Ontario
Specify:
Canada
Specify:
U.S.A.
Specify:
Other
Specify:
MISCELLANEOUS INFORMATION
Please enter any additional information we may find useful for finding an appropriate opportunity for you. (SIC or NAIC codes, how long you have been searching for an acquisition, etc.)
