Seller Form

Seller Form

CONTACT INFORMATION

Name:*

Station:*

Station Address:*

Contact:

Income and Expenses Statement

Monthly Income:

Source	Gross Income	Profit Margin	Gross Profit
Convenience Store:	R	%	R
Atm:	R	%	R
Bakery:	R	%	R
Fast Foods:	R	%	R
Cell Phone / Telkom:	R	%	R
Franchise:	R	%	R
Lotto:	R	%	R
Prepaid Electricity Card:	R	%	R
Sub Rent of Workshop/Offices/Other:	R	%	R
Car Wash:	R	%	R
	R	%	R
	R	%	R
Income from Petrol Sales:		Cpl	R
Income from Diesel (Cash Sales):		Cpl	R
Income from Diesel (Card Sales):		Cpl	R
		Cpl	R
Income from Oil Sales:	R	%	R
		Total Income:	R

Monthly Expenses:

Accounting & Audit Fees:

R

Advertising including Yellow Pages:

R

Bank & Credit card charges:

R

Cash In Transit:

R

Cleaning material:

R

Computer Expenses:

R

Consumables f-court, shop & c-wash:

R

Donations:

R

Electricity & Water:

R

Equipment Repairs & Maintenance:

R

Franchise Fees Forecourt % T/O:

R

Franchise Fees shop % T/O:

R

Franchise Fees Car-Wash %T/O:

R

Fuel evaporation/calibration/waste:

R

Fuel Guarantee:

R

Garden maintenance:

R

Insurance & Licenses:

R

Labour Consultants:

R

Leases & Hire Purchases:

R

Membership FRA etc:

R

M.I.B.C.O. Levies (dealer contribution):

R

Misc. & Maintenance:

R

Packaging:

R

PAYE contributions:

R

Pension contributions:

R

Personnel Expenses:

R

Postage, printing & stationary:

R

Pest Control:

R

Rental forecourt (Excl. VAT):

R

Rental shop (Excl. VAT):

R

Rental PEC:

R

Rental VERIPHONE:

R

Security Alarm system:

R

Security Money collection (……………….Guards):

R

Shrinkage in Shop (% of Turnover):

R

Skills Levy (1% of wages):

R

Speedpoint:

R

Staff Salaries incl. manager:

R

Staff wages:

R

Subscription Fees:

R

Telephone & Cellular Phone:

R

Transport cost for staff:

R

Unemployment Insurance Fund (U.I.F.):

R

Uniform & Cleaning:

R

Union Contributions:

R

Vehicles maintenance & petrol:

R

Waste & sewerage removal:

R

R

R

R

R

Total Expenses:

R

Yearly Cash Flow:

Total
Income:

-

Total
Expenses:

=

Monthly Nett
Profit:

X

Annualized
12 Months:

=

Yearly Nett Profit:

Assets:

Stock: Fuel

Stock: C/Store

Stock: Other

Petrol Station Price Excluding Stock:

Petrol Station Price Excluding Stock Including Property:

Please describe your station, amount of pumps, nozzles, tanks etc:

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