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Surveys
2011
April
S
Small Business
Small Business
Western Southern Financial Group Confidential Business Survey
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Name of Business
Contact Information
*
First Name
:
*
Last Name
:
Address 1
:
Address 2
:
City
:
State
:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
District of Columbia
Zip
:
Phone
:
Email Address
:
Title
Type of Business
Form of Business
"C" Corporation
"S" Corporation
Sole Proprietor
Partnership
Ltd Partnership
Ltd Corporation
Annual Sales/Income
Number of Employees
Total payroll
Do you have the following?
Business plan
Employee manual
Mission Statement
Exit Plan
Annual Budget
Are other family members involved in the business? Please describe.
ALL INFORMATION WILL BE KEPT ABSOLUTELY CONFIDENTIAL
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