Franchise Application
Franchise Application
Fields marked with
*
are mandatory.
Personal Information
*
First Name :
Gender :
Male
Female
Date :
*
Last Name :
Social Security # :
*
Birth Date :
Select Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Select Date
01
02
03
04
05
06
07
08
09
10
11
12
13
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31
*
Present Address :
US Citizen :
Yes
No
Home Ownership :
Own
Renting
*
City :
*
Email :
Marital Status :
Single
Married
*
Country :
Select Country
Canada
Mexico
USA
United Kingdom
*
Mobile Phone :
Spouse Name :
*
State / Province :
Select State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Home Phone :
Spouse Birth Date :
Select Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Select Date
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
*
ZIP / Postal Code :
Best Time to Call :
Select
Morning: 8 - 10
Morning: 10 - 12
Afternoon: 12 - 2
Afternoon: 2 - 4
Evening: 4 - 6
Evening: 6 - 8
How long at this address? (Yrs) :
Area / Location Preferences
Preference 1 :
Preference 2 :
Preference 3 :
Assets and Liabilities
ASSETS
LIABILITIES
Cash on Hand & in Banks ($) :
Mortgages ($) :
Marketable Securities ($) :
Accounts Payable ($) :
Accounts / Notes Receivable ($) :
Notes Payable ($) :
Retirement Plans (IRA / 401k, etc.) ($) :
Loans On Life Insurance ($) :
Real Estate ($) :
Credit Cards (total balance) ($) :
Personal Property ($) :
Unpaid Taxes ($) :
Business Holdings ($) :
Other Liabilities ($) :
Life Insurance ($) :
Description :
Description :
Total Liabilities ($) :
Total Assets ($) :
Total Net Worth ($) :
Please attach most recent 30 days statement of asset validation. E.g. 1. Bank statements 2. Retirement accounts 3. Mortgage statements 4. Stocks/Bonds
Upload Asset Validation Documents :
Retirement Account Statements :
Bank Statements :
Mortgage Statements :
Real Estate 1
Address :
Date Purchased :
Original Cost :
Present Value :
Mortgage Balance :
Real Estate 2
Address :
Date Purchased :
Original Cost :
Present Value :
Mortgage Balance :
Annual Sources of Income
Salary ($) :
Investment ($) :
Real Estate Income ($) :
Other ($) :
Description :
Total ($) :
Total Contingent Liabilities
Do you have any contingent liabilities for guarantees, endorsements, leases etc ? :
Yes
No
Legal Judgement :
Income Taxes :
Loan Co-signature :
Total :
Other Special Debt :
Questionnaire
When would you be ready to invest in your franchise if you were approved ? :
Have you ever been convicted of a felony? :
Yes
No
Have you been approved for financing? :
Yes
No
Who will be responsible for the daily operation of your store? :
If so, explain :
Amount Approved ($) :
Why do you think this franchise will enable you to reach your personal goals? :
Have you ever filed for bankruptcy? :
Yes
No
Amount of cash available for investment? :
Date Filed :
Would this business be your sole income source? :
Yes
No
Date Discharged :
Military Experience
*
Military Experience? :
Yes
No
Dates of Service :
Country/Branch of Service :
Discharge Status :
Upload DD214 :
Please list the two main questions you have about this business opportunity
Question1 :
Question2 :
Release and Authorization
I authorize POS Franchising, LLC to make investigations of any credit bureau or financial institution, to investigate the references and statements submitted, to obtain information regarding employment, credit, banks and savings accounts, as needed, to process this qualification report. I authorize POS Franchising, LLC to complete a background check to include criminal history. I further authorize all parties contracted on behalf of POS Franchising, LLC to release this information. I indemnify and hold harmless POS Franchising, LLC, its officers, directors, partners, managers, agents, employees, servants, contractors, sub-contractors, successors, and/or assignees from any and all liability in connection with such inquiries or contacts. I also certify that all information in this application is true and complete. Processing of this application will not begin until complete information is submitted to POS Franchising, LLC.
*
I agree to the above terms and conditions
*
Electronic Signature :