Client Name:_________________________________________
Full legal name of the client [partnership, individual, corporation, professional corporation or other.]
Entity To Be Valued:__________________________________
(or: To-Be-Named)
Type of Entity:
(Family) Limited Partnership (FLP;) General Partnership (GP;) Limited Liability Company (LLC;) C Corporation; S Corporation. [Please Check.]
Date of Formation______________ To Be Formed. State of Organization or Incorporation_____________
Principal Business Location:______________________
Purpose and Intended Use of the Appraisal:_______________________ Gift tax purposes (gift made/being made;) Estate Tax purposes; Inter-family sale of assets; Charitable Gift; Charitable Remainder Trust; Other__________
Please describe the proposed transaction:
Effective Date of the appraisal______________________________
General Partners of the FLP:__________________________(if known or readily available)
Managing Member(s) of the LLC:____________________________________(ditto)
Interest(s) To Be Valued:_____________________
For example, a 5% limited partnership interest, a 20% non-managing interest in an LLC, or a 20% general partnership interest.
For Existing Entities:
Financial Statements available since _________
Nature of the Financial Statements (Check all that apply)
Audited; Reviewed; Compiled; Internal Data Only; Tax Returns [Cash/Accrual basis;] Unknown at this time.
Asset Composition & Estimated Values
Please describe and provide values for the assets held by the entity to be valued. _____________________________________________
Source of the Estimated Asset Values:
Appraisal; Brokerage statements; Management Estimates; Other:
Does the Entity Have Liabilities ? Please describe.
Known Deadlines or Desired Timetable
____________________________________________
Your Name:______________________________
Title:_______________________
Firm:_______________________
Street Address 1:_______________________________
Street Address 2:_______________________________
City:______________________________
State:_____
Zip Code/Postal Code:___________________
E-mail:______________________________
Telephone___________________________
Fax:______________________________
Relationship To Client:
Client; Attorney; CPA; Business Owner/Partner; Estate Planner; Other:
Deliver the Proposal by: E-Mail with hard copy by First Class Mail or E-Mail only [Check One.]
Please print, complete and fax the form to the number listed below, or scan and e-mail..
If you have any question, please call 203-325-2703
or e-mail: mailto:jlp@NYNJCT-BV.com.
P.O. Box 2392
Darien, CT 06820-0392
Voice: (203) 325-2703