ASSET HOLDING FLP/LLC/CORP.
VALUATION PROPOSAL REQUEST FORM

JLP&Co.LLC will prepare a proposal to value your asset-holding entity or other business interest, and any fractional interest thereof . Please print the form, then complete the necessary information, and fax the form to us; the fax number is listed near the bottom of this form; you can also scan and e-mail . A proposal can be delivered to you by fax, USPS, Fedex or e-mail. If you have any question about this form, please call us [203-325-2703] or e-mail [jlp@NYNJCT-BV.com]. This form may not be applicable to certain situations. The information you provide will be treated in strictest confidence and will not be used for any other purpose but to prepare a proposal. Thank you.

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.



J.L. PIERSON & CO. LLC
Business Valuation : NY, NJ , CT, ETC.

368 Heights Road #2392
Darien, CT 06820
Voice: (203) 325-2703


E-mail: jlp@NYNJCT-BV.com
W3: http://jlpierson.com
W3: http://NYNJCT-BV.com
Copyright 1996, 2012, J.L. Pierson & Co. LLC Revised --01/28/12