Can Your Company Offer Stock to the Public Using the Small Business Forms?
Find Out in as little as 30 Minutes.
Open Line is a No-Cost, fast-moving 30 minute consultation in which a capital markets advisor will help you determine whether your company qualifies for using the Small Business Issuer Forms adopted by the SEC. This consultation normally costs $500.00. Appointments are granted on a first-come, first-served basis.
Begin by filling out this form. What follows is a series of questions to determine your potential for engaging in a successful public offering. The advisor will review this information and will be ready for you at the appointed time. To make the most of the appointed time the form must be completely filled out.
IMPORTANT: PLEASE READ
QUESTIONS:
1. In which industry do you conduct the majority of your business?
Technology,
Internet or Telecom Computer
- VARHardware/Software Professional
Services, Accountants, Legal or Finance Retail,Consumers,
Food Service, Sports or Entertainment Manufacturing
- High Tech or Traditional Oil,
Gas, Energy or Mining Automotive,
Transportation or Aerospace Education,
Health Care, Biotech or Social Assistance Agriculture,
Farming or Environmental Other
2. What is your primary product or service? Please type answer:
3. How long have you been in business? 6 months
months - 1 year
2 years
5 years
10 years
over
10 years
4. How is your business organized? Sole
Proprietorship
Corporation
S
Corporation
Partnership
LLC
Other
5. What stage of development best describes your company? Start
Up Research
and Development Only Prototype
Completed
Pre-Beta
Trials or Surveys Beta
Deployment/Testing
Pre-Production
In
Production, but not yet Generating Sales
Generating
Sales, but not Profitable
Generating
Sales and Profitable
6. What is your current geographic market? Local
Statewide
Regional
National
International
7. What is the size of your market? (in annual dollar sales)
8. What is the estimated growth for your product/service? (in annual dollar sales)
9. What are your expected/forecasted sales for:
Next Year:
Year after next:
10. What are gross margins for your Company?
11. What is the estimated target market/industry gross margins for product/service?
12. Choose the option that best describes the pricing power for you product/service: High Medium Low
13. Are you cash flow, operating cash flow and/or operating income positive? At least one of the above None of the above
If none of the above, when do you estimate or forecast when your
company will be positive for cash flow, operating cash flow and operating income?
14. What is the current book value for your business?
15. What is the current working capital for your business?
16. What is your debt position?
Current :
Long-term:
17. Do you have an in-house controller? YesNo
18. Does that person hold an accounting degree or a CPA designation? YesNo
19. What internal accounting system is used?
20. Is the accounting bookkeeping period being closed monthly or quarterly? Monthly Quarterly
21. Do you intend to change audit firms or accountants in the next fiscal year period? Yes
No
22. How did you discover GoPublicToday.com or hear about our services?
23. How have you been funded in the past? Debt Equity
Other
Please Explain:
24. What form of funding/financing do you expect in the future? Debt
Equity Other
Please Explain:
25. What type of barriers to entry exist in your marketplace?
26. Explain your product/service differentiation (price, quality or unique service/product):
27. How many executive manager level officers at the Company?
29. How much have your sales grown over the last year? No
Sales Yet
Negative
SalesGrowth 0
- 10% 10
- 20% 20
- 50% 50
- 100% More than 100%
30. What is your most recent 12 month profit/loss?
31. What is your company's current net worth?
32. What percentage of your revenues does your largest client represent? 1
- 10% 10
- 20% 20
- 35% 35
- 50% 50
- 75% 75
- 100% No
Sales Yet
33. How many employees do you have?
34. How many years of combined experience does your executive management team have in the industry? (including yourself)
35. Do you hold any patents or other significant intellectual
property that gives your company distinct competitive advantage? yes no If "yes" explain:
36. Does your business require the use of another company's
patent(s), trademark(s), copyright(s) or rights to generate a
significant portion of your revenue? yes no If "yes" explain:
37. How much financing have you received in the last year?
38. What amount of capital are you seeking from a public offering?
39. How will you use the funds raised through a public offering?Please type answer:
40. What is your projected revenue in Year 1 after going public?
41. What is your projected revenue in Year 2 after going public?
42. What is your projected revenue in Year 3 after going public?
43. Please describe in detail what the sources of your revenue are or will be. Please be as specific as possible. Please type answer:
44. Assuming you go public, when do you project that you will break even?
Currently Profitable 0 - 6 months 6 months - 1 year 1 - 2 years 2 - 3 years 3 - 4 years Over 4 years
45. Are your clients, customers or consumers potential investors in your company? yes No
46. Are your close business contacts or friends potential investors in your company? yes No
47. Are you under contract with any source that has rights to stock in your company? yes No
48. Is your company involved in any type of lawsuit? yes No
49. Rate the complexity to the average investor of understanding your business model and objectives: Simple, any adult would understand it. Moderate, need general knowledge to understand it. Hard, need specific knowledge of the industry to understand it. Impossible, only a few experts would understand the complexity.
50. How long does it take to explain to a potential investor why they should invest in your company? Less than 5 minutes 5 - 10 minutes 10 - 15 minutes 15 - 30 minutes More than 30 minutes
51. In what state (or province) will your primary office be located?(i.e. California, etc.) Please type answer:
52. Do you have a website? yes no If "yes":
53. Where did you hear about GoPublicToday.com? Please type answer:
54.
Any additional comments:
55. Business Plan Review. If you have a business plan you would like to have reviewed, please upload up to 5 relevant documents here.
56. Do you prefer to trade on OTC BBPink SheetsAMEX NASDAQ SC
Note: Print this out before you click submit, so you have copy on hand during the consultation.
