Business Owner Needs Analysis

Business Name *

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Number of Employees at your business *

Of the goals listed below, choose (many or none) what is important to you as the business owner.

Covering business debt

Protecting your business from a key employee's departure

Protecting your family's income in the event of your death

Recieving tax-efficient benefits paid with company dollars

Efficiently transferring my business interest in the event of my disability,

retirement, or death

Receiving a fair price for my business interest

Any other important information you would like to share about your business?

Disclaimer: By filling out this form I am giving expressed consent to Planting Seeds Financial to use my information for the purposes of agent/client privlidges. This information is being given at will to Planting Seeds Financial, LLC. Planting Seeds Financial nor its affilliates will use any information from this form for use for any reason other than stated above.