Confidential Personal Statement and Franchise Application

This application does not commit you to buy a franchise. It merely gives both you and us a starting point to determine if our Franchise is right for you.

I understand that the information I am receiving from Sola Franchise Corporation or from any of their employees, agents, or franchisees is highly confidential and is being made available to me because of this application, and I will hold it in the strictest confidence.

yesno

Upon completion, we will immediately send you our Franchise Offering Circular with full details.

(* required)

Personal Information

Name:*

Email:*

Phone:*

Age:

SSN:

Marital Staus:

Spouse's Name:

No. of Children:

Children's Ages:

Residential Information

Address:

City:

State:

Zip:

Country:

Business Information

Current Occupation:

Position:

How Long:

Address:

City:

State:

Zip:

Country:

Phone:

Education Information

Select the highest level of education completed:

High School College 1 yr. College 2 yr. College 3 yr. College 4 yr. Bachelor's Degree Master's Degree Doctorate/PhD. Other

Describe any training in marketing, management, real estate, academia or other business:

Describe any experience which would help you to own a business:

Personal Reference
(Friends, Neighbors, Business Associates)

Name	Address	Occupation	Yrs. Known

Credit Reference

Address	Account #	Telephone

What Are Your Geographical Areas of Interest? (Location City, State)

1st Choice: 2nd Choice: 3rd Choice:

Will You Devote Full-Time to This Business? yes no

If no, please explain:

Will Your Spouse Be Involved in This Business? yes no

Are You Considering A Partner? yes no

If so, who?



Total Capital Available to Invest in this Business:

Have You Ever Been Involved in a Bankruptcy? no yes

If yes, please explain:

Are You Currently Involved in a Lawsuit or Legal Actions? no yes

If yes, please explain:

How Did You Learn About the Franchise Program?

Financials

Please Provide a List of Your Financial Assets:

Cash on hand or in banks:

U.S. Government Securities:

Amounts and Loans Receivable:

Notes Receivable, not discounted:

Life insurance, Cash Surrender Value:

Stocks, Bonds, Money Market:

Real Estate:

Automobiles:

Other Assets (Itemize):

Please Provide a List of Your Financial Liabilities:

Notes Payable to Bank:

Notes Payable to Others, unsecured:

Loans against life insurance:

Accounts Payable:

Interest Payable:

Taxes and Assessments:

Mortgages Payable on Real Estate:

Brokers margin accounts:

Other liabilities (Itemize):

Annual Income:

Salary:
(Exclude bonus)

Spouses Salary:
(Exclude bonus)

Securities Income:

Rentals:

Other:1. Commission/Bonuses: 2. 3. 4.

Annual Expenditures: (Exclude ordinary living expenses)

Mortgage:

Real Estate payment(s):

Rent:

Income Taxes:

Insurance Premiums:

Other: (Include installment payments and other real estate)

1. 2. 3. 4.

I understand submitting this form authorizes the release and verifcation of credit information to Sola Franchise Corporation.

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