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1

Basic information

Name of Company

Company Website

Industry/ Sector

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2

Contact Details

Name

Title

Email

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3

Geographical Data

Country(ies) of Incorporation

Country(ies) where Revenue is primarily produced

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4

Last Financial Year End

Date (MM//DD/YYYY)

Revenue (US$)

Gross Profit (US$)

Net Income (US$)

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5

Estimated Current Financial Year End

Date (MM//DD/YYYY)

Revenue (US$)

Gross Profit (US$)

Net Income (US$)

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6

Do you have a data room open?

Do you have a data room open?

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7

What Accounting Software do you use

What Accounting Software (if any) do you use (eg. Xero, Quickbooks, Oracle NetSuite, SAGE, MYOB etc)8. Do you have existing debt outstanding? If so, how much (US$)

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8

Do you have existing debt outstanding?

Do you have existing debt outstanding? If so, how much (US$)

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9

How much financing are you looking for?

How much financing are you looking for?

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10

What is your target date for receiving funding?

What is your target date for receiving funding?

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