1. Are you aware of any circumstances in the industry or market area that may adversely affect future profitability of the business?* Yes No Please explain2. Are there any revenues or expenses of the business that are not clearly reflected in its financial statement?* Yes No Please explain3. Is the business in default of any of its financial or contractual obligations?* Yes No Please explain4. Has the business or any of its owners been the subject of any bankruptcy filings, assignments for benefit of creditors or insolvency proceeding of any kind during the last five years, or consulted with any attorney or advisor regarding such proceedings?* Yes No Please explain5. Are there any individual customers who account for more than 10% of annual gross sales?* Yes No Please list each by name and indicate the approximate percentage of annual gross sales and any relationships to the business or its owners.6. Are there any commitments to employees or independent contractors regarding future compensation increases?* Yes No Please explain*7. Are there suppliers who have a personal or special relationship with the business or its owners?* Yes No Please explain*8. Are any of the employees or independent contractors related to any of the owners of the business, or one another?* Yes No Please list them by name and describe their relationship.*9. Have you had or do you anticipate any disputes with the Landlord or problem with the Premises the business occupies?* Yes No Please explain*10. Are there any terms or conditions of the premises lease with which the business or the Landlord is not in full compliance?* Yes No Please explain*11. Have there been any deaths, violent crimes or other criminal activity on the premises within the last three years?* Yes No Please explain*12. Are you aware of any hazardous substance, material or products on or near the premises within the last three years?* Yes No Please explain*13. Is there any equipment used in the business that it does not own?* Yes No Please explain*14. Is there any equipment used in the business that is not in good operating condition, or for which maintenance has been deferred?* Yes No Please explain*15. Does the business have a franchise, distributorship or licensing agreement?* Yes No Please explain*16. Is the business or its operator required to have any licenses or permits other than a local business licenses?* Yes No Please explain the type of license and requirements of obtaining that license.*17. Must the new owner personally qualify for any licenses or permit?* Yes No 18. Are you aware of any pending zoning changes, redevelopment or nearby construction that might affect your business?* Yes No Please explain*19. Are there any alleged violations filed or under investigation by authorities issuing licenses or permits by the following agencies?* Yes No Please explain*20. Have you ever had any violations from any of the following? (Select all that apply)* Police Health Department Fire Department Building Inspector Zoning Commission Water Pollution Control Agency OSHA EEOC EDD Alcohol Beverage Control Board of Equalization Franchise Tax Record Other None Please Explain Any "YES" Answers Here:21. Does the Business Have Any of the Following?* Union or other employment contracts Any employee without a completed INS Form I-9 on file Employee stock ownership plan (ESOP) Unfunded pension liabilities Profit sharing plan Back wages or claims for same Unpaid medical or other insurance premiums Lease agreements (other than the premises) Equipment maintained agreements Advertising contracts (including Yellow Pages) Other outstanding contracts and agreements Pending litigation Unresolved insurance claims Product liability exposure Customer warranty obligations Pending tax or Worker's Compensation refunds Anticipated suppliers rebates None Please Explain and "YES" Answers Here:22. Are there any other facts or conditions not disclosed above that may adversely affect the operation of the business, a buyer's decision to purchase it or the price he might pay for it?* Yes No If "Yes" please explain:Name* First Last Business Name* Owner(s)* Corporate Title*OwnerPresidentCEOSole ProprietorFounderPartnerDirectorAddress* City, State, Zip* Email Date* MM slash DD slash YYYY Signature* Δ
