Sample Franchise Application

Beard Papa�s Sweet Caf�

1001 Avenue of the Americas, Suite 1110

New York, New York 10018

�� 212-382-4627
Fax: 212-382-4628

FRANCHISE APPLICATION

Except to the extent necessary to process this application, otherwise described below, or required by law, we will keep your financial and personal information confidential.� We will not contact your current employer without your consent.

Instructions:

� Complete and return this application in connection with your interest in being approved to become a Beard Papa�s franchisee

� Complete this application using a typewriter or print neatly (it will be scanned electronically)

� Each person or entity that would have an interest in the franchise must submit an application (a married couple may complete a single form)

� Documents listed on page 8 must be submitted as part of this application

Application Date:

How did you first hear about our franchise program?:

(please select one)

□ Website

□ Internet articles

□ Existing franchisee

□ Newspaper advertisement

□ Newspaper article

□ Other

PERSONAL INFORMATION

Name:		US Citizenship or Permanent Resident Alien Status
Name:	First Middle�� Last	US Citizenship or Permanent Resident Alien Status
Social Security #:		Check One Box:	□ US Citizen
Date of Birth:		Check One Box:	□ Permanent Resident Alien

Current Home Address:		Check One Box:	□ Own □ Rent
	Number and Street
		Lived at this address for:
	State, City and Zip Code		Years Months

Last Prior �Home Address: (Applicant)		Check One Box:	□ Own □ Rent
	Number and Street
		Lived at this address for:
	State, City and Zip Code		Years Months

Last Prior �Home Address: (Co-Applicant)		Check One Box:	□ Own □ Rent
	Number and Street
		Lived at this address for:
	State, City and Zip Code		Years Months

Contact Information	Applicant	Co-Applicant
Home:
Work/Office:
Fax:
Mobile:
E-mail:

Marital Status:	□ Single	□ Married
		Spouse�s Name:
		Spouse�s Name:	First ��Middle�� Last
		Would your spouse have an active role in the business?		□ Yes	□ No
		If �Yes� then describe your spouse�s anticipated role:




		Would your spouse have an ownership interest in the business?		□ Yes	□ No
		*If �Yes� then your spouse must apply with you to become a franchisee, and your spouse must provide the information for Co-Applicant.*

Complete this section for Co-Applicant only if Applicant and Co-Applicant are a married couple applying together.

Social Security #:

Check One

Box:

□ US Citizen

Date of Birth:

□ Permanent Resident Alien

Number of Dependents:

Ages of Children:

	Applicant	Co-Applicant	If �Yes� to any of the following questions, then provide complete explanation and details.
Have you ever been convicted of a crime, other than a minor traffic violation?	□ Yes □ No	□ Yes □ No
Do you have any felony charges pending, or are you under indictment?	□ Yes □ No	□ Yes □ No
Have you ever been the subject of a petition in bankruptcy?	□ Yes □ No	□ Yes □ No

YOUR INTEREST IN BECOMING A BEARD PAPA�S FRANCHISEE

Why do you want to become a Beard Papa�s franchisee?

GEOGRAPHIC INTEREST

Please tell us about any specific area or site you have in mind.� (Please note that approval of your application will not imply any development rights to a site or area you identify)

EDUCATION

Applicant

Did you graduate from high school?

□ �Yes

□ No

If no, what was the last year that you completed?

□ �9

□ �10

□ 11

College or University	Years Attended	Year Graduated	Major	Degree

Do you speak English fluently?

□ �Yes

□ No

What other languages of any, do you speak fluently?

Co-Applicant

Did you graduate from high school?

□ �Yes

□ No

If no, what was the last year that you completed?

□ �9

□ �10

□ 11

College or University	Years Attended	Year Graduated	Major	Degree

Do you speak English fluently?

□ �Yes

□ No

What other languages of any, do you speak fluently?

BUSINESS EXPERIENCE

	Applicant	Co-Applicant	If �Yes� to any of the following questions, then provide complete details, including name, state, and nature of your involvement.
Do you now or have you ever owned, managed or held an interest in any dessert or bakery business?	□ Yes	□ Yes

	□ No	□ No


Do you currently have an interest in any other business?	□ Yes	□ Yes

	□ No	□ No

Have you ever been a franchisee with respect to a business not identified above?	□ Yes	□ Yes

	□ No	□ No

�Applicant

Current Employer (Name, Address)	Position Details (Title, Responsibilities, etc.)	Yearly Salary (excluding bonus and commissions)	Name and phone number of the person to whom you report	Dates Employed (From � To)

Previous Employer (Name, Address)	Position Details (Title, Responsibilities, etc.)	Yearly Salary (excluding bonus and commissions)	Name and phone number of the person to whom you report	Dates Employed (From � To)

Previous Employer (Name, Address)	Position Details (Title, Responsibilities, etc.)	Yearly Salary (excluding bonus and commissions)	Name and phone number of the person to whom you report	Dates Employed (From � To)

Co-Applicant

Current Employer (Name, Address)	Position Details (Title, Responsibilities, etc.)	Yearly Salary (excluding bonus and commissions)	Name and phone number of the person to whom you report	Dates Employed (From � To)

Previous Employer (Name, Address)	Position Details (Title, Responsibilities, etc.)	Yearly Salary (excluding bonus and commissions)	Name and phone number of the person to whom you report	Dates Employed (From � To)

Previous Employer (Name, Address)	Position Details (Title, Responsibilities, etc.)	Yearly Salary (excluding bonus and commissions)	Name and phone number of the person to whom you report	Dates Employed (From � To)

OWNERSHIP OF FRANCHISE AND MANAGEMENT OF CAF�

Would any person or entity, other than you have an interest in the franchise?	□ Yes	If �Yes,� list each other person and entity who would have an interest in the business:
	□ No


Who will be the operating partner(s)?			A total of at least 40 hours/week must be spent in the caf� by the operating partner(s) and managers who have completed the Operations training with us.




Do you consider yourself able to undertake the physical tasks necessary to operate a Beard Papa�s Caf� on a day-to-day basis?	□ Yes	Describe how you will be involved in the day-to-day operation of the caf�:

	□ No

INVESTMENT FINANCING**

A. What is your total anticipated Investment to open for business?		$________________

B. What portion of the Investment would you pay in cash?		$________________
List the sources of capital that you plan to use to cover the portion of the Investment above that you plan to pay in cash (e.g. savings account, stocks, etc.)
Sources	Amount





C. What portion of the Investment would your partner(s) pay in cash?		$________________
D. What portion of the Investment are you and your partner(s) borrowing?		$________________
List the sources of capital that you plan to use to cover the portion of the Investment above that you plan to pay in cash (e.g. savings account, stocks, etc.)
Sources	Amount




Total (B thru D above)		$________________

** IMPORTANT NOTE: The approval of your application will not imply that Beard Papa�s has attempted to asses whether you have reasonably estimated your total anticipated Investment.�

PERSONAL FINANCIAL STATEMENT

�� As of Application Date

ASSETS	Applicant	Co-Applicant
Cash in banks including savings, checking, etc. (Schedule 1)	$	$
Marketable securities, stocks, bonds (Schedule 1)
401K, IRA, or other retirement accounts (Schedule 1)
Real estate - primary residence (Schedule 2)
Real estate � other (Schedule 2)
Interests held in other businesses
Other Assets (Itemize)



Subtotal	$	$
TOTAL ASSETS (add subtotals from both columns)		$_____________________

LIABILITIES	Applicant	Co-Applicant
Mortgage Notes � secured by primary residence (Schedule 2)	$	$
Mortgage Notes � secured by other real estate (Schedule 2)
Loans Payable (not secured by real estate) (Schedule 3)
Credit card debt, and other revolving debt
Real estate � other (Schedule 2)
Other Debts, Liabilities, and Financial Obligations (Itemize)



Subtotal	$	$
TOTAL LIABILITIES (add subtotals from both columns)		$_____________________

NET WORTH (equals Total Assets Minus Total Liabilities)

$_____________________

PRESENT ANNUAL INCOME

	Applicant	Co-Applicant
Salary	$	$
Bonus and Commissions
Dividends
Real Estate (e.g. rental income, etc.)
Other �Income (Itemize)



Subtotal	$	$

SCHEDULES TO PERSONAL FINANCIAL STATEMENT (Attach additional sheets if necessary)

Schedule 1 � Asset Accounts and Individually Held Securities

Financial Institution & Account No. (or Number and Name of Securities)	Type of Account, Fund or Security	Balance or Market Value	Outstanding Loans (e.g. Margin balance)	Owner of Record

Schedule 2 � Real Estate

Property Address & Description �(e.g. single family home, etc.)	Assessed Market Value	Mortgage & Leins	Total Annual Payments of Mortgage and Leins	$ Equity Owned by Applicant(s)

Schedule 3 � Loans Payable (not secured by real estate)

Lender	Loan Type	Balance	Monthly Payment	Maturity/Pay Off

Please note, the follow documents must be submitted with this application to be considered completed.� Muginoho USA, Inc. may request additional documentation and information before rendering a decision on this application.

� Last 2 months statement for each account listed in Schedule 1 (obtain an updated statement from your financial institution if the one you have is more than 90 days old);

� Property tax statement for each property listed in Schedule 2;

� If any required document cannot be provided, then a written explanation of the reasons why that required document is not available.

By signing below:

� I am representing and warranting that the information in this application (including information in the documents that I submit as part of my application) is true and correct.

� I understand that Muginoho USA, Inc. will rely on this information when determining whether to approve my application.� If Muginoho USA, Inc. approves my application, and later determines that the information I provided was materially false or incomplete, then Muginoho USA, Inc. will have a right to terminate the franchise that I acquire, which among other things required that I be of good character.

� I hereby authorize Muginoho USA, Inc. (and its affiliates and authorized agents) to make any additional credit, background, and character checks that Muginoho USA, Inc. or its affiliates deem appropriate, including obtaining of a person credit report.� If my application is approved, then this authorization shall continue as long as I am in the process of developing a Beard Papa�s Caf�, or I remain a Beard Papa�s franchisee, or I have any obligations to Muginoho USA, Inc or its affiliates, and any information obtained may be used by Muginoho USA, Inc. and its affiliates in an attempt to enforce my obligations to Muginoho USA, Inc. or its affiliates.

� I hearby authorize all persons, schools, banks and financial institutions, past or present employers, credit bureaus, and law enforcement agencies to release to Muginoho USA, Inc. (and its affiliates and authorized agents) any information about me that they possess, without qualification or restriction, and I hereby release them from any liability for complying with this authorization.� I authorize that a photocopy or facsimile or this release be considered as valid as the original.

� I am warranting and representing that I do not currently have any interest in a bakery or desserts business that would result in a violation of the covenants against competition contained in the franchise agreement governing the business I am seeking to acquire.

� I understand that if my application is approved, and I acquire a Beard Papa�s franchise, then Muginoho USA, Inc. and its affiliates may, but shall have no obligation to, from time to time extend credit to me in connection with my operation of a Beard Papa�s Caf�, including but not limited to my purchases of Beard Papa�s brand products.

	SIGNATURE:
		Applicant

	SIGNATURE:
		Co-Applicant

Except to the extent necessary to process this application, otherwise described below, or required by law, we and our affiliates will keep your financial and personal information confidential.� We will not contact your current employer without your consent.

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