Company Website:
Primary Contact:
Business Name of Investor,  Bank, Group and/or Corporation:
Mailing Address (Street Address):
City:
State/Province:
Zip/Postal Code:
Country:
Phone number of Primary Contact:
E-Mail Address:
Fax:

Specific search requirements:
1. Asset size ($million/billion):
2. Funding required:
3. Country:
4. Do your require a partner?
5. Capitalization available to purchase ($ ($ million/billion):
6. Geographic location(s):
7. To assist us in understanding your needs, whata areare your plans for obtaining funding?
8. Do you have a business plan?
9. Do you have a strategic plan?
10. Do you have a Board of Directors established?
11. Will you leave existing management in place?
12. Will you require third party due diligence?
13. Is there any information you can share about youyour interests and/or goals in this venture?
14. How did you hear about us?
15. Internet search, which engine?
16. Your question(s) or information:
17. Please limit this to 900 characters.

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