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Request a Proposal for Intellectual Property, Intangible or Specialty Asset
Name

Name

Full legal name of individual or entity with ownership of the asset

State of Organization or Incorporation

State of Organization or Incorporation

State or country of holding owner.

Primary Location

Primary Location

Address (including City, State and Country) of Principal Location

Description

Description

Description of asset to be valued including countries where revenues maybe obtained

Growth

Growth

Provide a brief description of the most recent revenue growth and projected future growth of any royalties or income from the asset

Book Value

Book Value

Recorded cost of asset (include a description of prior encumbrances/ collateralizations if applicable)

Purpose

Purpose

What is the purpose or intended use of the valuation or analysis?

Effective Date

Effective Date

What is the date of analysis or valuation?

Additional Information

Additional Information

Other comments or questions

Address Proposal To:

Address Proposal To:

First Name

Last Name

Company

Address

Address 2

Address 3

City

State / Province

Country

Postal Code

Day Phone

Evening Phone

Relationship to Entity

Relationship to Entity

For example Owner, Attorney, CPA, Other (and if applicable, are you or do you represent a buyer or seller)

Email Address

Email Address


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