Download our EBITDA template and assess a company's operational profitability using the income statement and cash flow statement. This EBITDA template will show you how to calculate EBITDA using the income statement and cash flow statement.Proof of all payments for health care, including health insurance premiums, co-payments, and other out-of-pocket expenses, for the past 3 months. Learn how to value your business with the EBITDA formula so that you can demonstrate your worth to buyers and investors. You must fill out this Affidavit completely, and provide accurate information. "Pro Forma Entity" shall have the meaning provided in the definition of the term Acquired EBITDA.