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Feasibility Questionnaire

If you are interested in getting some feedback from us with regard to the feasibility of implementing an ESOP, complete the following questionnaire.

The questions which allow for multiple answers are marked with a "**". To select a variety of answers from the list, hold down your Control Key [Ctrl] and use your mouse to pick the answers from the list. The fields marked ** must be completed.

ALL INFORMATION IS STRICTLY CONFIDENTIAL AND WILL NOT BE USED FOR ANY OTHER PURPOSE.

1. Are you a private company?

Yes
No

2. How many employees in your company?
3. How many employees do you wish to include in an ESOP?
4. What is the approximate annual revenue?
5. What is the average annual growth rate in number of employees in percent? %
6. What industry are you in?
7. How many shareholders currently?
8. Are these principle shareholders willing to reduce their ownership? Yes
No
9. Have the employees been promised some kind of employee ownership in the past? Yes
No
10.** What are the main objectives of the current owner(s) in providing an ESOP?

Attracting Employees
Retain Employees
Improve productivity
Provide incentive plan
Leave the business
Grow commitment and company
Other response

  If you selected "Other response", please explain.
11. Do you currently distribute corporate financial information to employees? Yes
No
12. Do you have difficulty attracting or retaining key individuals to your company? Yes
No
13. Do you currently have an incentive plan in place? Yes
No
14.** What is your exit strategy (ie. Sale, IPO, Merger etc.)?

IPO
Merger
Sale to management/employee
Sale to 3rd party
Other

  If you selected "Other", please explain
15. Do you have foreign subsidiaries? Yes
No
16. Additional information which may help us understand your company
  Your Full Name **
  Title / Position
  Name of Company
  Address
  City
  State/Province
  Zip/Postal Code
  Country
  E-mail where we can write to you. **
  Address of your Web Site (if applicable)
  Telephone Number
  Please tell us how you found out about our Web Site. Select as many as you like.**

Internet Search Engine
Newsletter
Recommended by a Friend
Magazine
Newspaper
Other

  If you used a search engine, can you tell us the phrase you used to locate our site? (e.g. ESOP)
  Please click on the submit button to send your form by e-mail to ESOP BUILDERS INC.

 
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