You can download the pdf version of our Practice Financial Disclosure form by clicking here, or complete our online version below. You can only save data entered on the pdf version after it has been downloaded to your computer, and then you can take the time to work on it at your own pace. Once the pdf version is complete, please email the form to or fax to 866-512-1792.

Please contact us at 855-428-2225, or via email, if you have any questions.

If you don’t have an adobe reader you can get one for free at

Seller Financial Disclosure
Firm Name
Seller’s Name*
Firm Address
Office Phone Number
Cell Phone
Home Phone
Confidential Email Address
Direct Correspondence to*
Website Address
Legal Entity Form
Number of Shareholders/Partners
Reason for Selling
Have you attempted to sell before
Are your employees aware of the sale?
Professional Organizations
Year business established?
Any Existing Liens on the practice
Is there any pending litigation?
Brief history of your firm
Is practice relocatable?
What tax software do you use?
What Accounting & Bookkeeping software do you use?
What other software do you use?
What is your hourly rate?
Total cash basis revenue in calendar year 2017
Total cash basis revenue in calendar year 2018
Current YTD cash basis revenue
Estimated value of equipment
Desired asking price
Would you consider seller financing?
If yes, how much would you want as a down payment?
What is your desired term and interest rate?
Will you sign a non-compete agreement?
How many office locations?
How long at current location
Office Rent
Office sq ft
Lease exp. date
Office lease assumable?
Description of office
Any disputes with the landlord?
Approximate % of clients come in for an appt
Walk-in %
Mail-in/Email or Other Electronic Method %
#1040’s prepared in the last full calendar year?
Avg. fee of 1040’s
Total 1040 Revenue
# entities filed in the last full calendar year?
Avg. fee of entities
Audit & Review Income in last full calendar year?
Bookkeeping revenue in last full calendar year?
Number of bookkeeping clients
Payroll Service Revenue in last full calendar year
Number of payroll clients
Average number of payees per client
Other Income in last full calendar year?
Other Income Type
Would you like to remain after the sale?
Will any employees likely stay after the sale?
What positions would like to stay?
Anything else we should know?
How did you hear about us?
Prior calendar year P&L

File(s) size limit is 20MB.