Open a Goodbye Graffiti Franchise in the USA



Please complete all sections of this form (type or print clearly).Return it immediately via email to franchising@.Your information will be held?in strict confidence with no obligation to either party.This is not a contract. Thank you.Personal Information FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?? / FORMTEXT ?? / FORMTEXT ???? FORMTEXT ??? - FORMTEXT ?? - FORMTEXT ????Last NameFirst NameMiddle NameDate of BirthSocial Security NumberPhysical Address: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?? FORMTEXT ?????StreetCityStateZip CodeMailing Address: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?? FORMTEXT ?????StreetCityStateZip Code( FORMTEXT ???) FORMTEXT ???- FORMTEXT ????( FORMTEXT ???) FORMTEXT ???- FORMTEXT ????( FORMTEXT ???) FORMTEXT ???- FORMTEXT ????( FORMTEXT ???) FORMTEXT ???- FORMTEXT ????Home TelephoneWork PhoneMobile PhoneFax NumberWhen is the most convenient time to call? FORMTEXT ?????E-mail address: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Current EmployerOccupation & Title FORMTEXT ????? FORMTEXT ?? / FORMTEXT ?? / FORMTEXT ???? FORMTEXT ??? - FORMTEXT ?? - FORMTEXT ????Spouse’s Full Name (if applicable)Date of BirthSocial Security Number FORMTEXT ????? FORMTEXT ?????Spouse’s Current EmployerSpouse’s Occupation & Title FORMTEXT ?????Names and ages of children (if applicable)Referring Broker (If Applicable)What is the full name of the broker that referred you to us? FORMTEXT ?????Address: FORMTEXT ?????City: FORMTEXT ?????State: FORMTEXT ?? Zip: FORMTEXT ?????Telephone: ( FORMTEXT ???) FORMTEXT ???- FORMTEXT ????Email: FORMTEXT ?????TIN: FORMTEXT ?????Education FORMTEXT ????? FORMTEXT ?????, FORMTEXT ?? FORMTEXT ????? FORMTEXT ?????High SchoolCity, StateHighest Level CompletedDegree/Certification FORMTEXT ????? FORMTEXT ?????, FORMTEXT ?? FORMTEXT ????? FORMTEXT ?????College (Undergraduate)City, StateHighest Level CompletedDegree/Certification FORMTEXT ????? FORMTEXT ?????, FORMTEXT ?? FORMTEXT ????? FORMTEXT ?????OtherCity, StateHighest Level CompletedDegree/Certification FORMTEXT ????? FORMTEXT ?????, FORMTEXT ?? FORMTEXT ????? FORMTEXT ?????Employment History FORMTEXT ????? FORMTEXT ?????( FORMTEXT ???) FORMTEXT ???- FORMTEXT ???? FORMTEXT ?????CompanyAddress, City, StatePhone NumberDates (From – To) FORMTEXT ????? FORMTEXT ?????TitleResponsibilities FORMTEXT ????? FORMTEXT ?????( FORMTEXT ???) FORMTEXT ???- FORMTEXT ???? FORMTEXT ?????CompanyAddress, City, StatePhone NumberDates (From – To) FORMTEXT ????? FORMTEXT ?????TitleResponsibilities FORMTEXT ????? FORMTEXT ?????( FORMTEXT ???) FORMTEXT ???- FORMTEXT ???? FORMTEXT ?????CompanyAddress, City, StatePhone NumberDates (From – To) FORMTEXT ????? FORMTEXT ?????TitleResponsibilitiesDo you or have you ever owned any business not listed above? FORMTEXT ?????If yes, please list and provide a brief description: FORMTEXT ?????What do you like most about any of your jobs or businesses? FORMTEXT ?????What do you like least about any of your jobs or businesses? FORMTEXT ?????What is your greatest achievement? FORMTEXT ?????Your strengths are: FORMTEXT ?????Your weaknesses are: FORMTEXT ?????How would you rate your interest in owning a new business on a scale of 1 (low) to 10 (high)? FORMCHECKBOX 1 FORMCHECKBOX 2 FORMCHECKBOX 3 FORMCHECKBOX 4 FORMCHECKBOX 5 FORMCHECKBOX 6 FORMCHECKBOX 7 FORMCHECKBOX 8 FORMCHECKBOX 9 FORMCHECKBOX 101397468379095[The remainder of this page is intentionally left blank]00[The remainder of this page is intentionally left blank]Financial InformationDo you own or rent your home? FORMCHECKBOX Own FORMCHECKBOX RentYears at present address: FORMTEXT ?????Years in present City or Town: FORMTEXT ?????Mortgage/Rent: $ FORMTEXT ?????/monthMortgage/Rent payable to: FORMTEXT ?????Do you own automobiles? FORMCHECKBOX Yes FORMCHECKBOX No If yes, what is the make, model, and year of each vehicle? FORMTEXT ?????Have you ever declared bankruptcy? FORMCHECKBOX Yes FORMCHECKBOX NoIf yes, where and when? FORMTEXT ?????What is your intended cash investment? FORMTEXT ?????Do you have a financing source? FORMTEXT ????? Source: FORMTEXT ?????Method: FORMTEXT ?????AssetsLiabilitiesCash on Hand and in Banks$ FORMTEXT ?????Notes Payable to Bank$ FORMTEXT ?????US Government Securities$ FORMTEXT ?????Unpaid Income Tax$ FORMTEXT ?????Listed Securities & Current Market Value$ FORMTEXT ?????Real Estate Mortgages Payable$ FORMTEXT ?????Unlisted Securities$ FORMTEXT ?????Chattel Mortgages & Other Liens Payable$ FORMTEXT ?????Owned Automobiles & Personal Property$ FORMTEXT ?????Auto Liens Payable$ FORMTEXT ?????Cash Value Life Insurance$ FORMTEXT ?????Other Debts Itemized$ FORMTEXT ?????Retirement Plans & IRA’s$ FORMTEXT ?????Notes Payable$ FORMTEXT ?????Real Estate Owned$ FORMTEXT ?????Total Credit Card Debt$ FORMTEXT ?????Other Assets$ FORMTEXT ?????Other Liabilities$ FORMTEXT ?????Total Assets$ FORMTEXT ?????Total Liabilities$ FORMTEXT ?????Net Worth: $ FORMTEXT ?????Income — SelfIncome — SpouseCurrent Annual Salary$ FORMTEXT ?????Current Annual Salary$ FORMTEXT ?????Bonus Income$ FORMTEXT ?????Bonus Income$ FORMTEXT ?????Interest Income$ FORMTEXT ?????Interest Income$ FORMTEXT ?????Other Income$ FORMTEXT ?????Other Income$ FORMTEXT ?????Total Income$ FORMTEXT ?????Total Income$ FORMTEXT ?????Net Income: $ FORMTEXT ?????1511768573405[The remainder of this page is intentionally left blank]00[The remainder of this page is intentionally left blank]General InformationDo you plan to operate this business yourself? FORMCHECKBOX Yes FORMCHECKBOX NoIf not, who will operate this business? FORMTEXT ?????In order of preference, please list the areas where you would like to have your office:1. City: FORMTEXT ?????State: FORMTEXT ?????County: FORMTEXT ?????2. City: FORMTEXT ?????State: FORMTEXT ?????County: FORMTEXT ?????3. City: FORMTEXT ?????State: FORMTEXT ?????County: FORMTEXT ?????4. City: FORMTEXT ?????State: FORMTEXT ?????County: FORMTEXT ?????5. Other: FORMTEXT ?????Why do you wish to purchase a franchise rather than starting your own business or being employed by an existing company? FORMTEXT ?????If your application is approved, when would you prefer to open your franchise? FORMTEXT ?????How did you hear about us? FORMTEXT ????? I certify that the information provided on this questionnaire is complete and accurate. I hereby authorize verification of the above information. It is understood that this is a preliminary application and does not bind any party with any obligation. FORMTEXT ????? FORMTEXT ?????SignatureDateSignature of SpouseDate FORMTEXT ????? FORMTEXT ?????Name (Print)Name (Print)45339001687195dand@00dand@3943351691640Toll Free (844) 648-1414Mobile (480) 331-317100Toll Free (844) 648-1414Mobile (480) 331-3171 ................
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