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Request Valuation Proposal Form

Only the fields with an asterisk(*) are required.
Entity Information
* Type of entity to be valued:
Entity Name:
Nature of Business
General description of the entity's business and SIC (Standard Industrial Code as shown on tax return) if appropriate.
Date of Formation:
State of Organization or Incorporation:
Principal Location (City, State):
Facilities:
Revenue:
Assets:
Book Value:
Profitablilty:
Any Pertinent Agreements?
Please briefly describe any agreements that are relevant to the appraisal service requested. For example:
  • Shareholder agreement restricting sales of common stock to third parties
  • Partnership agreement requiring 75% vote of limited partners to remove general partners
Financial Statements Available Since:
Nature of Financial Statements Available:
Contingent Liabilities / Nonoperating Assets
PPlease briefly describe contingent liabilities and/or nonoperating assets. For example:
  • Summer home in Utah
  • Property leased to third party
  • Boat, planes, etc., not used in the business
Known Deadlines or Desired Timetable
If there is a known deadline (e.g., an estate tax filing date), please indicate. FMV Opinions strives to complete every project within 6 weeks of obtaining the necessary information from our clients.
Contact Information
* First Name:
* Last Name:
* Email:
Company:
Title:
Phone:
Referred By:
Relationship to Client:
Address:
City:
State:
Zip:
Country:
Other Questions / Comments
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Securities offered through FMV Opinion's subsidiary, FMV Capital Markets, LLC, Member FINRA/SIPC     |     Regulatory Disclosures