Quantum Business Solutions Network  
Buyer's Profile and Criteria For Acquisition Form
Date:
Name:
Business:
Address:
Title:
City:
State / Zip:
Phone:
Cell:
Email:
Fax:
How did you learn of our company?
Referred by:
Insert Name and Phone Number
Internet ad :
 Insert web site
Other:
 Please describe
Present Occupation or Business:
Business and Industry Preference (i.e., Mfg., Distribution, Service, Retail, etc.)
 1
2
3
Location
Preference:
1
2
3
How long have you been looking
for a business?:

Minimum annual income required?:

Do you require immediate income?:

How much cash is available for down payment?:
$
Source of Down Payment?:

When will it be available?:

Resume enclosed?:

When do you want to take possession?:

My estimated net worth:
$ 		Who, besides yourself, will be
involved in the decision?:

What businesses have you investigated?:

  Other Remarks:
The undersigned certifies that this information was provided by him/her and is true and correct.
Date: _______/________/________
Print Name: _______________________________________
Signature:_________________________________________
A PERSONAL OR BUSINESS FINANCIAL STATEMENT WILL BE REQUIRED OF ALL
POTENTIAL BUYERS BEFORE RECEIVING FINANCIAL INFORMATION ON ANY LISTING.
Fax this executed document to: (866) 480-7471
Quantum Business Solutions Network, Inc.
19900 MacArthur Boulevard, 11th Floor Irvine, California 92612
Telephone: (877) Qbs-net2 (727-6382) Facsimile: (866) 480-7471
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