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Intangible Asset Request Form
  • ‣ Business Information
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  • Business Name*
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  • Business Address (Line 1)*
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  • Business Address (Line 2)*If applicable
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  • City*
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  • State*
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  • Zip Code*
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  • ‣ Contact Information
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  • Name*Full name
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  • Email Address*Valid email address
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  • Contact Phone*Format: 555-555-5555
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  • Business Phone*Format: 555-555-5555
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  • ‣ Valuation Information
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  • Purpose of Valuation*The purpose of the valuation dictates certain methodologies and circumstances to be considered, if not known leave blank
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  • Valuation Date*Use the date selection icon, or type in manualy (mm/dd/yyyy)
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  • ‣ Company Information
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  • Annual Sales*
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  • No. of Employees*
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  • No. of Locations*
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  • Business Structure*
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  • SIC Code*
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  • Business Description*
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  • Accounting Method*
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  • Audited Financial Statements*
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  • ‣ Please Indicate the Type of Intangible Assets
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  • Customer Relationship:*
    Yes
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  • Patents:*
    Yes
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  • Trademarks:*
    Yes
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  • Trade Names:*
    Yes
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  • Proprietary Formulas:*
    Yes
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  • Covenants Not to Compete:*
    Yes
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  • Preferred Contracts:*
    Yes
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  • Proprietary Technology:*
    Yes
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  • In-Process R&D:*
    Yes
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  • Employee Agreements:*
    Yes
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  • Other Intangible Assets:*
    Yes
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  • ‣ Financial Information
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  • We will require the following information, if applicable to your valuation:*Please check if available
    Five Years of Federal Business Income Tax Returns
    Balance Sheet and Income Statement as of the Valuation Date
    Quickbooks or Equivalent Historical Five Years Records (Balance Sheet, P/L)
    Lease Agreements (if applicable)
    Real Estate Appraisal (if applicable)
    Machinery & Equipment Appraisal (if applicable)
    Business Plan (if available)
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  • Upload Financial Documents*If desired, please upload the above checked information here. If you do not want to upload these files now you can send them via email to info@eacvaluations.com Upload Now
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