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Seller Intake Questionnaire

The information you provide is kept strictly confidential and will be used only to help FirmBridge prepare a valuation and anonymized practice listing. Nothing will be published without your review and approval.

Full Name *

Firm Name *

Phone *

Email Address *

Best Time to Contact

Confidentiality Level Requested

City / Region *

Year Established *

Designation(s) HeldCPACACGACMAOther

Entity Structure *

Number of Partners / Owners *

Gross Revenue — Last Year *

Gross Revenue — This Year *

Gross Revenue — Two Years Ago

Net Income / SDE — This Year *

Net Income / SDE — Last Year *

Net Income / SDE — Two Years Ago

% Revenue — T1 Personal Tax

% Revenue — T2 Corporate Tax

% Revenue — Bookkeeping / Compilations

% Revenue — Review / Audit

% Revenue — Advisory / Consulting

Top 5 Clients as % of Revenue

Billing / Practice Management Software Used

Number of Active T1 Clients

Number of Active T2 Clients

Number of Bookkeeping / Monthly Clients

Average Client Tenure

Estimated Annual Client Attrition (%)

Any Long-Term Client Contracts in Place?YesNo

Additional Staff Information

Office Arrangement *

Lease Term Remaining / Assignable?

Equipment to Be Included in Sale

Software Subscriptions to Be Transferred

Any Outstanding Debts or Liens Tied to the Practice? *YesNo

Debt / Lien Details *

Reason for Selling *

Desired Closing Timeline *

Willing to Offer Vendor Financing / Take-Back?YesNoPossibly

Transition Period You’re Able to Offer

Asking Price Expectation

Is Price Negotiable?YesNoPossibly

When / How Should Staff Be Informed?

When / How Should Clients Be Informed?

Restrictions on How the Practice Can Be Advertised

Acknowledgement

I confirm that the information provided above is accurate to the best of my knowledge and authorize FirmBridge to prepare a confidential valuation and marketing summary based on this information.

Seller Acknowledgement *I confirm and agree to the acknowledgement above.

Signature *

Date *

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