Asset & Liability Statement


dd-mm-yyyy



Location

i.e. Additional information regarding your existing practice(s) or experience as an Associate

Assets

Liabilities

Current Value £s
Approximate Loan outstanding £s

No. of other UK properties

Total Estimated Value £s
Total Estimated Mortgages & Loans £s

Approximate current value in £s
Total credit card debt in £s

Available cash savings in £s
Total Estimated Other Loans in £s
Total of all other assets not already detailed in £s
Total of all other Liabilities not already detailed in £s

I hereby give my consent for The Crowley Partnership Ltd to hold my personal details in connection with the possible acquisition of a practice; whether it be Dental, Veterinary or another similar business.

As part of this registration The Crowley Partnership Ltd agree to provide me with potentially privileged and sensitive information on the understanding that I agree to the following:

1) All privileged information furnished will be deemed confidential, except information which is generally available to the public. The information presented will not be used in any way for personal benefit other than the purchase of the practice for which I have received information from The Crowley Partnership Ltd.

2) Not to reveal to anyone, except immediate advisors, that the practice disclosed by The Crowley Partnership Ltd is for sale, and to ask said advisors to also respect this Confidentiality Agreement.

3) Not to contact the practice owner, employees, suppliers, clients, competitors, solicitor, accountant, or other similar advisors for any practice for which The Crowley Partnership Ltd have provided me with details.

Furthermore, not to make contact with any part of the NHS regarding the sale of any practice, either verbally or written, for which The Crowley Partnership Ltd have provided me with details, without the specific written permission of the SELLER.

4) That, until permission is specifically granted by The Crowley Partnership Ltd, all communications between BUYER and SELLER will be held through The Crowley Partnership Ltd.

5) To the understanding that, although certain information has been and will be provided which I may consider to be relevant, The Crowley Partnership Ltd makes no representation or warranty (implied of expressed) as to its accuracy or completeness. I agree to perform due diligence to my own satisfaction.

6) I have read and accept the Privacy Policy for The Crowley Partnership Ltd.

I hereby acknowledge The Crowley Partnership Ltd to be the agency providing contact, for any practice where they have supplied me with information.