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The NBBC New Firm Application Form

All information in this form is confidential

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Firm Information

Firm Name *

Year of Incorporation *

Ownership

Owner's Name 1

Percentage of Ownership 1

Owner's Name 2

Percentage of Ownership 2

Owner's Name 3

Percentage of Ownership 3

Owner's Name 4

Percentage of Ownership 4

Total Number of Team Members (not including ownership)

Brokers *

Administrators *

Analyst *

Valuation *

Exit Planning *

Appraiser (machining/equipment) *

Other *

HQ Location (City, State): *

Within what mile radius from your HQ do 80% of your listings come from (Primary Market)? *

Any Additional Office Locations (City, State): *

What are your primary market(s) from each additonal office location? *

What is your typical range of deal size–low to high ( Enterprise Value)? *

Total Years of Business Brokerage Experience (All people within firm) *

Have You Previously Owned a Business Other than Your Brokerage Firm? *

Yes
No

Are You a Member of a Franchise? *

Yes
No

If Yes, Which One

List Your Professional Credentials or Designations & Year Received *

Are you FINRA Licensed? (assuming most will be "no") *

Yes
No

Name of Person Licensed

Which FINRA licenses?

Additional FINRA License Holders (Name, License Type):

Do you have an E&O policy? *

Yes
No

Are you real estate licensed? *

Yes
No

In what state(s) are you licensed?

About Your Firm

What terminology do you use for your firm and team? (No right or wrong answer) *

Business Broker
Business Intermediary
M&A Broker
M&A Advisor
Investment Banker
Other

Does your firm use a virtual data room? If yes, which one? *

Yes
No

Which one? *

Does your firm use a CRM system? If yes, which one? *

Yes
No

Which one?

What are the Top 5 Industries You Have Completed the Most Deals In (Be as specific as possible)i.e Not professional services, instead accounting firms? *

Has Your Firm Closed 7 or More Deals in a Specific Industry(s)?

Yes
No

If yes, name of person(s) & industry(s) for each along with estimated total number of deals closed in each specific industry? *

Revenues & Opportunities

Firm Revenues

2026 YTD Total Revenue ($) *

2026 YTD Sell Side (%) *

2026 YTD Buy Side (%) *

2026 YTD Valuation (%) *

2026 YTD Other Services (%) *

2025 Total Revenue ($) *

2025 Sell Side (%) *

2025 Buy Side (%) *

2025 Valuation (%) *

2025 Other Services (%) *

2024 Total Revenue ($) *

2024 Sell Side (%) *

2024 Buy Side (%) *

2024 Valuation (%) *

2024 Other Services (%) *

Deals

Number of Closed Deals

Total number of deals since inception: *

Total Deals Closed

2026 YTD *

2025 *

2024 *

2023 *

Total Enterpise Value in Deals Closed

TEV in Closed Deals

2026 YTD *

2025 *

2024 *

2023 *

Largest Closed Deals (TEV)

Largest Closed Deals

2026 YTD *

2025 *

2024 *

2023 *

What are your closing ratios?

What are your closing ratios?

2026 YTD *

2025 *

2024 *

2023 *

References

Please list a professional reference whom you have worked with in the last three years. (i.e. M&A Attorney, CPA)

Reference 1 Full Name *

Reference 1 Relationship *

Reference 1 Company *

Reference 1 Phone *

Reference 1 Email Address *

Please list a Client reference whom you have worked with in the last three years.

Reference Client Full Name *

Reference Client Relationship *

Reference Client Company *

Reference Client Phone *

Reference Client Email Address *

Professional

Are you a part of any professional organizations? *

Yes
No

Please list professional organizations: *

List any awards you or your firm have received during your tenure in business brokerage

Signature

I certify that my answers are true and complete to the best of my knowledge. *

Clear Signature

Date *

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