Mobile - Business Brokerage Incorporated Business Brokerage Incorporated

Complete, Scan, Email (or Fax) Form
To: Linda Long, Sales Assistant
bbiemail@go2bbi.com
(800) 274-4272
(949) 715-2024 Fax.

No. Calif: Lee Ribolin
800-727-4272
lee@go2bbi.com

Client Resume & Application For BBI Personal Identification Number (PIN #) to access "Confidential Information Summaries" on Business Brokerage Listings.

NOTE: ALL DETAILS REMAIN CONFIDENTIAL AND ARE ONLY SHARED IF A BUYER REQUESTS A MEETING WITH THE SELLER OF A PRACTICE. PLEASE COMPLETE ALL SECTIONS TO INSURE YOU WILL BE CONSIDERED FOR A PRACTICE. THIS PAGE CAN BE COMPLETED FROM KEYBOARD. COMPLETE THIS FORM ONLINE. USE MOUSE FROM A COMPUTER OR FINGER FROM A TOUCHSCREEN DEVICE TO SIGN THE CONFIDENTIALITY AGREEMENT.

Complete, Scan, Email (or Fax) Form
To: Linda Long, Sales Assistant
bbiemail@go2bbi.com
(800) 274-4272
(949) 715-2024 Fax.

No. Calif: Lee Ribolin
800-727-4272
lee@go2bbi.com

Client Resume & Application For BBI Personal Identification Number (PIN #) to access "Confidential Information Summaries" on Business Brokerage Listings.

NNOTE: All details remain confidential and are only shared if a buyer requests a meeting with the seller of a practice. Please complete all sections to insure you will be considered for a practice.

TITLE:

FIRST NAME*:

LAST NAME*:

MI:

COMPANY:

STREET*:

CITY*:

STATE*:

ZIP*:

TELEPHONE OFFICE*:

TELEPHONE HOME*:

FAX NUMBER:

CELLULAR PHONE*:

YEAR OF BIRTH *:

LICENSES HELD:

SPOUSE'S NAME:

E-MAIL ADDRESS*:

WEBSITE:

EDUCATION (Provide Details Or Note N/A if Not Applicable)

UNDERGRAD SCHOOL*:

DEGREE*:

YR. GRAD*:

GRAD SCHOOL*:

DEGREE*:

YR. GRAD*:

EMPLOYMENT HISTORY (Provide Details at a minimum, for current Employment or Note N/A if Not Applicable)

PRESENT EMPLOYMENT*:

TITLE*:

START*:

END*:

FORMER EMPLOYMENT #1*:

TITLE*:

START*:

END*:

FORMER EMPLOYMENT #2*:

TITLE*:

START*:

END*:

CERTIFIED BY (FIRM)*:

CERT#*:

STATE*:

YEAR*:

ABOUT YOUR PRESENT PRACTICE (Note N/A in Practice Size if don't currently own a practice).

PRESENT PRACTICE*:
$

# PRINCIPALS:

# STAFF:

YOUR POSITION:

PARTNERS NAME:

SERVICES PROVIDED:

BILLING RATE PROFESSIONALS:
$ /HR

STAFF:
$ /HR

% ACCTG:
%

% TAX:
%

% MAS:
%

% AUDIT:
%

GL SOFTWARE::

TAX SOFTWARE:

SIZE PRACTICE WANTED:
$

AREA DESIRED:

MIX WANTED:

NET WORTH*:
$

DOWN PAYMENT AVAILABLE*:
$

FIVE YEAR GOAL:

LIFETIME GOAL:

COMMENTS, AFFILIATIONS, HOBBIES, INTEREST, AREAS OF EXPERTISE:

Note: The above information will be kept confidentially by Business Brokerage. Upon request for an interview with a prospective buyer, this resume will be given to the seller as part of the screening process.

Complete, Scan, Email (or Fax) Form
To: Linda Long, Sales Assistant
bbiemail@go2bbi.com
(800) 274-4272
(949) 715-2024 Fax.

No. Calif: Lee Ribolin
800-727-4272
lee@go2bbi.com

BLANKET AGREEMENT OF CONFIDENTIALITY.

Complete, Scan, Email (or Fax) Form
To: Linda Long, Sales Assistant
bbiemail@go2bbi.com
(800) 274-4272
(949) 715-2024 Fax.

No. Calif: Lee Ribolin
800-727-4272
lee@go2bbi.com

PLEASE FAX COMPLETED FORM BACK TO BUSINESS BROKERAGE AT 949-715-2024.

BLANKET AGREEMENT OF CONFIDENTIALITY.

In consideration of receiving the any Confidential Information Summary(s) which is/are provided to me, in trust, by E-Mail, FAX or otherwise, I hereby agree to the following:

I will not reveal or disclose either orally, in writing or otherwise; nor exhibit, nor photo copy, nor email or in any other way reproduce any information regarding the listings of BUSINESS BROKERAGE, INC. (including Confidential Information Summaries regarding specific listings), nor the name and/or address of the Seller, without the express written permission of BUSINESS BROKERAGE, INC.
I understand that BUSINESS BROKERAGE, INC. has a listing agreement with the owner of the business(es) described in their Confidential Information Summary(ies) which provides for a commission payment by the Seller. I agree that BUSINESS BROKERAGE, INC. is the procuring cause for said business(es) and shall deal through BUSINESS BROKERAGE, INC. exclusively.
BUSINESS BROKERAGE, INC. is an agent of the Seller only.

"If completing registration online, please sign using your mouse or sign with finger if using a touchscreen device"

SIGNATURE*:
("If completing registration online, please sign using your mouse or sign with finger if using a touchscreen device") on the box below

DATE:

FIRSTNAME*:

LASTNAME*:

MI*:

COMPANY:

STREET*:

CITY*:

STATE*:

ZIP*:

PHONE NUMBER*:

FAX NUMBER:

E-MAIL ADDRESS:

PLEASE SEND ME INFORMATION ON LISTINGS:

PLEASE SET AN INTERVIEW WITH LISTINGS:

David C. Smith
Founder

Lee Ribolin
Broker

Craig Van Laningham
Agent

Brandon Ribolin
Small Practice Specialist