RF GLOBAL HOLDINGS LLC -- COMPANY QUESTIONNAIRE

*Note: RF Global does not provide Reserve Funding Agreements to companies publicly listed in the U.S. and U.S. companies listed on a foreign exchange.

Instructions: Please enter the information requested below. Non-US Companies Only
Company Name *

Contact Person *

Position *

Full Address *
Street Address, City, State, ZIP & Country
Website *

Phone Number *

Cell Number *

Email *

Email

Business Type *

Fiscal Year End *

Currency *

Referred By *

Where is you Company Incorporated? *

With respect to the executive officers and directors, are more than 50% of them US Citizens or residents? *

With respect to company assets, are more than 50% located in the USA? *

With respect to outstanding voting securities of the company, are more than 50% indirectly or directly owned of record by residents of the USA? *

Is company business administered principally in the United States? *

Company Enterprise Value (equity + debt, pre-money) if known *

If Company is PUBLIC, Please answer the following questions:
Share Registry Address and Contact Details

ISIN

How many shares do you currently have issued and outstanding?

How many shares are currently owned by the officers and directors?

If Company is PRIVATE, Please answer the following questions:
When is your Company going Public?

Who is your Listing Agent and their Contact Information?

Both PUBLIC and PRIVATE companies, please answer the following:
Company Opportunities *

Company Challenges *

Use of Proceeds *

Over the next 18-24 months, how much capital is needed? *

Company's Board Criteria when evaluating a transaction *
Please provide at least three criteria
Reserve Funding Requested (in millions) Please note all values in USD only
Amount *

Type *
Equity Debt
Financial Details (in millions) Please note all values in USD only; You must provide the Revenue, EBITDA and Earnings for each requested year Revenue: The amount of money that a company actually received during a specific period; gross income EBITDA: "Earnings Before Interest, Taxes, Depreciation and Amortization"; EBITDA = Revenues - Expenses (excluding tax, interest, depreciation and amortization)
2009 *
Revenue, EBITDA, Earnings
2010 *
Revenue, EBITDA, Earnings
2011 *
Revenue, EBITDA, Earnings
2012 (current) *
Revenue, EBITDA, Earnings
2013 (projected) *
Revenue, EBITDA, Earnings
2014 (projected) *
Revenue, EBITDA, Earnings
Balance Sheet (in millions) Please note all values in USD only
Working Capital (Current Assets - Current Liabilities) *

Funded Debt *

Shareholder Equity *

EMF Form Builder

Report Abuse

public companies

reserve funding agreement

RF Global reserves the right to determine who referred us any business deal. The management decision will be final. RF Global Reserves the right to pay referral fee if it is legal at its own discretion.

RF Global's Company Questionnaire

If Company is PUBLIC, Please answer the following questions:

If Company is PRIVATE, Please answer the following questions:

Both PUBLIC and PRIVATE companies, please answer the following:

Reserve Funding Requested (in millions)

Financial Details (in millions)

Balance Sheet (in millions)

public companies

reserve funding agreement