Startup Financial Needs Assessment Form
Company Information
Field | Information |
|---|
Company Name | [Your Company Name] |
Industry Sector | [Industry Sector] |
Contact Person | [Contact Person] |
Email | [Your Company Email] |
Phone Number | [Your Company Number] |
Address | [Your Company Address] |
Website | [Your Company Website] |
Social Media Handles | [Your Company Social Media] |
Financial Needs Assessment
Category | Estimated Cost (USD) | Funding Source (if any) |
|---|
Startup Costs | $50,000 | Bootstrap funding |
Product Development | $20,000 | Angel investor |
Technology Infrastructure | $15,000 | Personal savings |
Legal and Compliance | $10,000 | Venture capital |
Marketing and Branding | $30,000 | Crowdfunding |
Initial Inventory | $5,000 | Loan from family |
Operating Expenses | | |
Rent and Utilities | $12,000 | Revenue from sales |
Personnel Costs | $40,000 | Grant funding |
Marketing Expenses | $25,000 | |
Administrative Expenses | $8,000 | |
Research and Development | $15,000 | |
Other (Specify) | $0 | |
Total Financial Needs | $220,000 | |
Comments/Notes:
Declaration
I confirm that the information provided above is accurate to the best of my knowledge.
Signature:
Date:
[Your Company Name] assures confidentiality of the provided information and will only use it for the purpose of assessing financial needs and providing relevant assistance.
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