Current status       Single Separated Married Divorced

   Number of minor children and ages    

   Home Payments     $     Own   Rent

       If Buying:
       Name of mortgagor    
       Mortgagors address    

   Home phone     
   Business phone 
   SSAN    
   Birthdate    
   Height          Weight     
   Physical limitations    
   Education
       Last year completed    
      Degrees, major    

   Current Employment    
       Address    
       Position    
       Salary    
       Date Started    
       Job Description    

   Previous Employment    
       Address    
       Position    
       Salary    
       Date Started          To     
       Job Description    

Spouse Information

   Name of Spouse     
   Business Phone    
   SSAN    
   Birthdate    
   Height          Weight     
   Physical limitations    
   Education
       Last year completed    
      Degrees, major    

   Current Employment    
       Address    
       Position    
       Salary    
       Date Started    
       Job Description    

   Previous Employment   
       Address    
       Position    
       Salary    
       Started          To     
       Job Description    

   Previous Business Owned:
       Have you ever owned your own franchise or other type of business:
       If so please give details:

      

Franchisee Financial Information
   Assets
       Cash in checking account    
       Cash in savings account    
   Liabilities
       Notes payable    
       Home mortgage balance    
  Fixed Assets
       Real Estate    
       Other Real Estate    
       Stocks and Bonds    
       Autos    
       Your own business    
       Money due you    
       Insurance, cash value    
       Other assets, describe    
      

                                               Total Assets                       

   Long Term Liabilities:   Describe
      

                                               Total Liabilities                   

                                               Net Worth                           

  How much capital can you allocate from the above sources to buy this franchise?
  

  If the required amount is not available, how would you pay for this franchise?
  

   Thoroughly explain your answers and any other strategies you may have for obtaining
   the required funds.  Any partners?  Investors?
  

  What is the minimum income you need to maintain your family during the first year of
   business?    

   From what source will it come?     

Business references, list three:

   Name    
   Address    
   Years Known    

   Name    
   Address    
   Years Known    

   Name    
   Address    
   Years Known    

Character references, other than employees and relatives, list three:

   Name    
   Address    
   Years Known    

   Name    
   Address    
   Years Known    

   Name    
   Address    
   Years Known    

Former addresses for the past five years
  
  
  
  

Business Goals
  

Are you willing to relocate?      Yes   No

When do you want to start our franchise operation?    

How did you become interested in this particular franchise?
    

State your own rationale for believing you can become successful operating one of our franchises?
  

By submitting this application, I certify that the enclosed information is complete and correct.

 
 Please Provide any additional information or
comments below.

 



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