Seller Registration

Thank you for taking the time to complete this form. The information will help us to be of best service to you. We require the information you provide to be truthful and accurate to the best of your knowledge. Please provide as much information as possible. If some of it is not handy, leave it blank and we will discuss it with you at a later stage.

  Business Details
     
Company Name:  
Legal Structure:  
Physical Address:  
   
City:  
Postal Code:  
Phone:  
Fax:  
Company E-Mail:  
Company Website:  
     
  General Information
     
Year Company Started:  
Segment:  
Products or Services:  
Manufacture or Distribute:  
Target Industry or Market:  
Competitors:  
Trade Associations:  
Licences:  
Trade Hours:  
     
  Facilities
     
Building Description:  
Property Size:  
Equipment Description:  
Seating Available:  
     
  Lease Information
     
Landlord:  
Period:  
Options:  
Escalation P/A:  
     
  Expenses
     
Rent: R  
Electricity and Water: R  
Gas: R  
Rates: R  
Refuse: R  
Security: R  
Parking: R  
Cleaning: R  
Pest Control: R  
Insurance: R  
Bookkeeper: R  
Signs: R  
Advertising: R  
Telephone: R  
Entertainment: R  
Bank Charges: R  
Licences: R  
Royalties: R  
UIF: R  
Maintenance: R  
Packaging: R  
V.A.T.: R  
Other:  
     
  Staff, Advisors and Owners
     
Employees:  
Casuals:  
Management:  
Unions:  
Salaries:  
Wages:  
Extra Notes:  
     
  Financial Information
     
Fixed Assets:  
Cash Balance:  
Investments Value:  
Current Assets:  
Current Liabilities:  
Debt - Long-Term:  
Debt - Short-Term:  
Annual Revenue:  
Cost Of Sales:  
Gross Profit:  
Operating Expenses:  
Net Income:  
Financials Available: Audited Accounts  
  Management Accounts  
  Including Cash  
  Excluding Cash  
     
  Selling Price
     
Price Required:  
Stock: Inclusive  
  Exclusive  
Stock Value:  
Purchase Terms:  
     
  Other Information
     
Reason For Selling:  
Comments:  
     
  Personal Information
     
First Name(s):  
Last Name:  
Title:  
I.D. Number:  
Home Address:  
   
Postal Address:  
   
Phone:  
Fax:  
Mobile:  
E-Mail Address *:  
     
   
     

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