Corporate Capital Resources LLC

Fact Finder: Preliminary Analysis Questionnaire

Corporate Financial Strategy Review

All information to be set forth in this questionnaire will be kept confidential. If the question is unclear or the data is not available, please estimate (including "est.") or leave blank. We will undoubtedly need to clarify a few points, so estimates are a good starting point.

Date:
Analysis Needed by (date):
Contact Person:
Company:
Address:
Locations in other states:
Telephone:
FAX:
Brief Description of Objectives (Create Market for Stock, Create Transition Strategy for Key Stockholders, ESOP Management LBO, Retention of Key Executives, etc):

Employee and Benefit Plan Data

Number of Employees

Total Non-Union Employees:
Total Unionized Employees:
Total Non-Union Working Less than 1,000 Hours Annually:
Total Unionized Working Less than 1,000 Hours Annually:
Total Division 1 Non-Union Employees:
Total Division 1 Unionized Employees:
Total Division 2 Non-Union Employees:
Total Division 2 Unionized Employees:
Total Division 3 Non-Union Employees:
Total Division 3 Unionized Employees:
Total Non-Union Payroll:
Total Unionized Payroll:
Total Compensation for Individuals Earning over $80,000:
Type(s) of Existing Profit-Sharing/Benefit Plan(s) (401k, Cafeteria Plan, etc):
Are All Employees Eligible To Be Covered by the Retirement/Benefit Plan?	Yes No Unsure
Amount of Current Annual Plan Contribution (Employer Portion Only):
Amount of Employee Contributions/ Deferrals:
Current Plan Assets Due to Employer Contributions:
Do Employees Direct the Choice of Investments in Their Plan?	Yes No Unsure

Corporate Financial Data

Type of Company ("C", Sub-S, Partnership, LLC, etc.):
If Sub-S, Effective Date of Election:
Date Company Established:
Primary Business Lines:

Fiscal Year End:
Long Term Debt? Terms?:

Gross Sales in Past Fiscal Year:
Sales This Year:
Last Year's Earnings Before Taxes (EBT):
Current Expected EBT
Projected Rate of Growth:
Total Income Taxes Paid Last Year:
Estimated Income Taxes This Year:
Appraised Value of Entity:
Appraised by Whom?:
Appraised When?:
Appraised for what Purpose?:
Buy-Sell Price Agreement?:
Current Retained Earnings in Excess of Bonding or Working Capital Needs:
Any NOL Carry-Forward Tax Credits Present or Projected?:	Yes No Unsure
Current Line of Credit (Used/Available):
Federal and State Corporate Tax Rate:
Book Value:

Shareholder Equity

Number and Classes of Shares Issued and Outstanding:

Number of Shares Owned by Individuals (or by groups if there are many)
1:	Currently Employed by Company?	Yes No
2:	Currently Employed by Company?	Yes No
3:	Currently Employed by Company?	Yes No
4:	Currently Employed by Company?	Yes No
5:	Currently Employed by Company?	Yes No
6:	Currently Employed by Company?	Yes No
Others 7:	Currently Employed by Company?	Yes No
Terms of any Restricted Shares (other than Buy/Sell Restrictions)

Is the Cost Basis in Any of the Above Shares Close to Current Estimated Value? If So, Please Indicate for Whom and the Approximate Basis:

If Stock Sale is Under Consideration:
Who?:
When?:
How Much?:
Who?:
When?:
How Much?:
Is Insurance in Place on Key Executives?:
What Total Premiums are Currently Required?
How is the Insurance Coverage Structured (Buy-Sell, Key Man, Cross Purchase, Corporately Owned, Split Dollar, etc)?:

Other Comments (Near Term Business Outlook, Opportunities, Unusual Problems, e.g. Old 'E&P' on Balance Sheet, etc):