Finance a Franchise by ebj11165

VIEWS: 24 PAGES: 46

More Info
									1   Introduction and completion guidelines
2   Section A : Application main page
3   Section B : To be completed by every shareholder, member or surety related to the applica
4   Section C : Business detail
6   Franchise Projected Cashflow
7   Day 1 Balance sheet
8   Franchisee Set-up Cost
9   Drivers and assumptions
elated to the applicant
home




                                       FRANCHISE AND
                                    FINANCE APPLICATION
            Initial franchise application:

SECTION A Initial franchise application to be completed by the representative shareholder

Annexures
   A1a    To be completed if a Company or Closed Corporation has not yet been incorporated
   A1b    To be completed if a Company or Closed Corporation has already been incorporated
   A2     Schedule of Shareholders / Sureties / Key Personnel



SECTION B Personal applications to be completed by every shareholder/surety related to the application

Annexures
    B1      Personal Income & Expenditure statement.
    B2      Personal Assets & Liabilities.
    B3      Security offered
    B4      Application to include signed "Ackowledgement form"
    B5      Detailed curriculum vitae.

            To be completed upon franchisor approval:

SECTION C Finance application to be completed by the representive shareholder

Annexures
   C1     Application to include signed "Declaration by Company or CC form" (See attached)
   C2     Business Plan compiled per FFC / Franchisor template




            This application and the information contained therein will be used by both the franchisor
            and the financial institution (if applicable) for their respective evaluation and approval
            procedures.


            TIPS on completing your application:

          * Complete & legible applications will always be considered more favourably. Please liase
            with your FFCconsultant regarding any aspect of the application which may not be clear.
* Mark applicable option with X
SECTION A - FRANCHISE APPLICATION
1. Applicant
Current or future trading name of the business :

Registered name of applicant if available :


Purpose of loan :               To establish a new business                  To acquire existing business           Upgrade an existing business

In case of an existing business - are you purchasing ?                 Shares / interest in the business               Assets of the business
                                                                                                                                  D   D    M     M    Y        Y
In case of an existing business - date of initial establishment ?

In case of new business to be established, what is your location preference ?

 1                                                      2                                                   3
                                                                                                                                SSSSS 1    M     M    Y        Y
Franchise Business Format                                   Format 1                             Projected commencement date:

2. Financing Structure ( A = B + C + D + E)
Total Set Up Costs (Vat incl) / Purchase Price                                                                              A

Shareholders Cash Contribution (Unencumbered & Non Interest Bearing)                                                        B

Other Sources of interest bearing finance:

● Proceeds of other loans                                                                                                   C     R

● Other                                                                                                                     D     R

● Commercial bank loan                                                                                                      E

3. Finance Sourcing
I intend to finance the complete set-up cost of the franchise with my own funds                                                                YES        NO

I shall apply for a business loan in my own capacity at a financial institution of my own choice                                               YES        NO

I engage Franchise Finance to assist me with a loan application at a participating financial institution.                                      YES        NO

4. Annexures to be attached
(Please note: Should you have your own versions, please attach in place of the templates provided)                              Yes       No    Annexure

Letter of Authorization (in case an entity has not been registered yet)                                                                              A1a
Resolution by shareholders or members                                                                                                                A1b
Schedule of Shareholders / Sureties / Key Personnel                                                                                                  A2
5. Declaration on behalf of applicant
I, _______________________________________________________, on behalf of the applicant, hereby declare that the information
provided in this Section A of the application form and Annexures, is to the best of my knowledge true, correct and accurate in all material
respects.
I acknowledge that failure to disclose any information that are relevant to this application, or the furnishing provision of any untrue, incorrect
or inaccurate information will render this application or any agreement or subsequent agreement entered into between the franchisor and
applicant (either personally or on behalf of any CC or Company),null and void.
I further acknowledge that this application does not constitute any form of agreement or contract whatsoever between the franchisor, and the
applicant, and is in no way binding on either party.
I acknowledge that in the event of the franchise application being successful and the provisional agreement is concluded between the
franchisor and myself, I will be required to complete Section C of this application for the purpose of submission of my loan application.


Signed at                                                                                      on

                                                                                                    WITNESSES
                                                                                                    1.
     On behalf of the applicant who warrants that he is authorized to do so.
                                                                                                    2.
  ANNEXURE "A1a" - Letter of Authorization

  We, the future Shareholders or Members of a Company or Close Corporation, to be incorporated;




Name:                                                                                  ID


  Signature                                                                            Date


Name:                                                                                  ID


  Signature                                                                            Date


Name:                                                                                  ID


  Signature                                                                            Date


Name:                                                                                  ID


  Signature                                                                            Date


Name:                                                                                  ID


  Signature                                                                            Date




  hereby authorize and nominate


Name:                                                                                  ID


  to sign, apply and submit any documentation required for the franchise and finance application as described in
  Sections A and C on our behalf.


  Signed and accepted at                                                               on




  Nominee
  ANNEXURE "A1b" - Resolution
  (To be printed on a company letterhead of an existing CC or PTY)

  We, the Shareholders / Members of;




Name:                                                                                  ID


  Signature                                                                            Date


Name:                                                                                  ID


  Signature                                                                            Date


Name:                                                                                  ID


  Signature                                                                            Date


Name:                                                                                  ID


  Signature                                                                            Date


Name:                                                                                  ID


  Signature                                                                            Date




  hereby authorize and nominate


Name:                                                                                  ID


  to sign, apply and submit any documentation required for the franchise and finance application as described in
  Sections A and C on our behalf.


  Signed and accepted at                                                               on




  Nominee
ANNEXURE "A2" - Schedule of Shareholders / Directors / Sureties / Key Personnel

         Initials & Surname               Capacity     % Share     Financial Contribution          Source           Gender    Race     Citizenship
                                                                   (Existing or intended)                            M/F     B/W/C/I




                                          TOTAL                  R


                                                                       Ownership                                        %
PDI Participation in -                                                Management                                        %
                                                                       Employees                                        %
                                                                       Ownership                                        %
PDI Youth (age 18 - 35) participation in -                            Management                                        %
                                                                       Employees                                        %
Total number of employees in the business

Notes
(i) The first person on the list should be the representative shareholder / member
(ii) Proof of source of financial contribution per shareholder will be required for financial application (Section B)
(iii)The total financial contribution must correspond with the Shareholders Cash Contribution listed in Section A
(iv) PDI - African, Indian and Coloured
(v) Only RSA citizen qualify for Khula indemnity
* Mark applicable option with X
SECTION B : PERSONAL APPLICATION
1. Personal Details - To be completed by each Shareholder & Surety if such Surety is not a Shareholder

Surname :                                                                                                                  Title                       Mr

First names :

Town and country of birth :                                                                                                          Gender            M              F

Nationality :                                                                            ID No :

Permanent SA Citizen :    YES          NO    E - mail address :

Tel No. (bus) :                                                                   Tel No. (home) :

Cellular :                                                                        Fax No :

Residential address

Period at present address :    Years              Months              Residential property is :      Owned            Rented       by       Self                Spouse

Postal address :

                                                                                                                                        Code

Drivers Licence :         YES          NO    Personal Income Tax No :

Number of dependants :                                Number of children                N/A             Their ages

2. Marital Status

Single

Married                                COP                          ANC with Accrual                    ANC without Accrual                        Tribal
                                                                                                                                        D     D    M        M     Y       Y
Divorced                      Was final divorce order granted ?       YES       NO        If yes, provide date of divorce decree :
                                                                                                                                        D     D    M        M     Y       Y
Widowed(er)                                                                                               Widowed since :
(Include copy of Contract if married ANC, copy of divorce decree)

3. If married please supply the following additional information about your spouse

Surname :                                                                                                                  Title

First names :

Town and country of birth :                                                                                                          Gender            M              F

Name of employer :

Employer's address :

                                                                                                                                        Code

Present position                                                                                   Annual income

4. Details of next of kin - 2 (not of the same address)

Initials and Surname :

Relationship :                                      Tel No :                                             Cellular :

Physical Address :

                                                                                                                                        Code

Initials and Surname :

Relationship :                                      Tel No :                                             Cellular :

Physical Address :

                                                                                                                                        Code
5. Employment history (from most recent)
Employer                                                       From                  To                     Last position held                Annual income

 1

 2
                                                          M    M    Y    Y    M   M       Y   Y
 3
(Kindly include a CV - See annexure checklist)

6. Education

Highest secondary qualification :                  Year passed :                     School :

If you have a degree or diploma, please specify :

If you have completed a formal apprenticeships or pupilage, please specify :

If you have any other formal business skills, please specify :

7. Computer Literacy

If you have completed formal PC literacy courses, please indicate disciplines :                              Excel      Word     Outlook Access Explorer   Other

If so, please attach certificate or confirmation of training provider.

Please provide full details of previous practical computer experience



8. Details of primary cheque / credit card / savings account
  Type of account          Bank / Institution                                Account number                                  Date opened         Credit Limit
          Self

 1 Cheque
                                                                                                                            M    M   Y   Y
 2 Credit card
                                                                                                                            M    M   Y   Y
 3 Savings
       Spouse
                                                                                                                            M    M   Y   Y
 1 Cheque
                                                                                                                            M    M   Y   Y
 2 Credit card
                                                                                                                            M    M   Y   Y
 3 Savings


9. Credit record

Have you ever had any judgments against you (are you blacklisted)?             YES        NO      If YES, please provide details :




Have you ever been sequestrated?                                               YES        NO      If YES, please provide details :




                                                                                                                                         D   D    M   M    Y    Y
If YES, have you been rehabilitated?                                           YES        NO      If YES, date rehabilitated :



Have you ever been found guilty of a criminal offence                          YES        NO      If YES, specify details
10. Previous business interests

If you had any previous active interest in any other business, please provide the following details:

Registered name:                                                                                                 Reg No :

Nature of business :
                          D     D       M   M   Y   Y
Date established :                                      Period involved :                                                Shareholding :                          %

Reason for departure :



11. Current business interests
Business Interest 1

Registered Name of business                                                                                           Reg No.

Nature of business

Interest held in capacity as shareholder of :                                    %           OR            Director / Managing Member           YES         NO
                                                                                                                                      D    D    M   M   Y        Y
Interest Capacity:              Active              Silent         Discretionary           Other       Interest held since:

Value of Interest:            Capital       R                                             Annual Income     R
Business Interest 2

Registered Name of business                                                                                           Reg No.

Nature of business

Interest held as:             Shareholder                          %     OR                 Director / Managing Member                    YES           NO
                                                                                                                                      D    D    M   M   Y        Y
Interest Capacity:              Active              Silent         Discretionary           Other       Interest held since:

Value of Interest:            Capital       R                                             Annual Income     R
Business Interest 3

Registered Name of business                                                                                           Reg No.

Nature of business

Interest held as:             Shareholder                          %     OR                 Director / Managing Member                    YES           NO
                                                                                                                                      D    D    M   M   Y        Y
Interest Capacity:              Active              Silent         Discretionary           Other       Interest held since:

Value of Interest:            Capital       R                                             Annual Income     R




Signed at                                                                                 on




Signature




Please e-mail to:
Or send to:                    Franchise Application Department
                               Postal address




                               or fax to:
Annexures to be attached to every individual application
(Please note: Should you have your own versions, please attach in place of the templates provided)                                    Yes   No   Annexure

Personal Income & Expenditure statement.                                                                                                            B1

Personal Assets & Liabilities.                                                                                                                      B2

Security offered                                                                                                                                    B3

Application to include signed "Ackowledgement form"                                                                                                 B4

Detailed curriculum vitae.                                                                                                                          B5

If Khula guarantee is required, latest personal SARS assessment is required.
Details/proof on the source of the financial (own)contribution of this shareholder to the venture

Copy of bank statements of shareholders personal accounts for the last 3 months
Documented proof of residential address as per FICA
Certified Copy of marriage certificate or divorce decree
Certified Copies of IDs

ANNEXURE "B1" - Personal Income & Expenditure of all prospective Shareholders
               Monthly income                              Self                    Spouse                               Monthly expenditure

Gross salary                                                                                        Bond repayment/Rent

Housing subsidy                                                                                     HP/Loan/Credit card

Car allowance                                                                                       Insurance (Life and sort-term)

Commission                                                                                          Domestic (water, lights, rates)

Overtime                                                                                            School and University fees

Other (specify)                                                                                     Transport

Other (specify)                                                                                     Maintenance (if divorced)

Other (specify)                                                                                     Subtotal (fixed expenses)

Other (specify)                                                                                     Other (specify)

Other (specify)                                                                                     Other (specify)

Other (specify)                                                                                     Other (specify)

TOTAL INCOME                                                                                        Other (specify)

Less: Pension/Medical aid/PAYE                                                                      Other (specify)

NET INCOME                                                                                          TOTAL EXPENSES
ANNEXURE "B2" - Statement of Assets and Liabilities
ASSETS
1. Fixed property registered in your name
City and Town property

Stand no                 City/Township   Purchase price      Date purchased   Fire insurance       Owner's valuation   Bank use

                                                                                               R

                                                                                               R
Farm and Small holding property

Stand no/Name of farm    City/Township   Purchase price      Date purchased   Fire insurance       Owner's valuation   Bank use

                                                                                               R

                                                                                               R
Property bought under deed of sale

Stand no/Name of farm    City/Township   Purchase price



2. Mortgage Bonds in own favour, i.e. where a bond is held over the fixed property of
another person. State first or subsequent bond(s) and give a description of property. State
the amount outstanding still receivable/Timeshare.                                                 Owner's valuation   Bank use




3. Stock - specify




4. Vehicles (state the year, make and model)




5. Miscellaneous movable property




6. Debtors (state the names)




7. Shares and/or loans (specify)
   Listed on the JSE




  Unlisted shares/Loans to private companies




Other investments, assets and business interests (specify)
8. Life policies
 Insurance Company                     Policy number                        Life cover             Ceded to           Surrender value




9. Credit balances (e.g. savings accounts, fixed deposits, etc.)

                                                                               Own Contribution Clean Force



TOTAL ASSETS


LIABILITIES (Amounts in Rand)                                                                                                            Amount Due
                              D    D    M       M   Y    Y
Liabilities stated as on:
1. Mortgage bonds (for amounts due under deed of sale)
Stand no/Name of farm          Town/City                Bondholder/Seller          Interest rate      Instalment           Expiry date




2. Term loans/personal loans (specify)


3. Owing under instalment sale agreements
   Type of asset e.g. vehicle, machinery, etc                   At which institution                          Instalments monthly




4. Income tax owing (state when due)


5. Owing to banks (state names and specify liabilities)




6. Owing in respect of credit cards (specify)




7. Other liabilities (describe and mention terms and conditions of repayment




TOTAL LIABILITIES

ASSETS LESS LIABILITIES

SURPLUS OF ASSETS OVER LIABILITIES

NOTARIAL BONDS (state over which assets and in favour of whom)
Contingent Liability

1. Property Leases
             Item                               Landlord                          Monthly Rental             Commencement Date                  Term




2. Suretyship
              In favour of                             At financial Institution               Details of security provided               Amount

                                                                                                                                          NIL




ANNEXURE "B3" - Security offered
Description of security available
                                    Type of security                                        Available (x)          Value         Owned            Bank use

First covering mortgage bonds - residential

Continuing covering mortgage bonds where another financial

institution or any other party holds prior ranking bonds.

NB: Consent of existing bondholder Essential.

Cession of listed shares on the JSE excluding any shares listed

in the Development Capital or Venture Capital sections of the JSE

Pledged Kruger Rands

Cession of fixed deposit

Cession of unit trust

Cession of life policy (Surrender value)

Other (specify)

1.

2.

3.
ANNEXURE "B4" - Acknowledgement Form
(*This section is to be completed by each Shareholder)


1. I ____________________________________________________ ID ______________________________warrant:
 -   that the information relating to my application provided in, Section B, of this application form dated __________________200__ , is true and correct to the
     best of my knowledge and belief; and
 -   I have not misrepresented any facts or statements;
 -   that the statement of personal assets and liabilities is complete, true and correct and all liabilities have been fully disclosed.

2. I acknowledge:
 -   that the bank, in processing this application, may require to access information about myself, recorded with any third party, including but not limited to,
     credit bureaus and any financial institutions and I hereby consent to the bank accessing and/or obtaining this information; and
 -   that, save for the obligation set out in this declaration, this application does not constitute any binding agreement on the bank, to provide the financing
     requested in this application. Should, however, the bank grant the financing requested, the bank will place reliance on the information provided herein,
     and should it, at any stage, come to the fore that any information was incorrect, the the bank reserves the right, if it is prior to the finance being provided,
     to withdraw such financing and if it is subsequent to the financing being provided, then to cancel such financing and to demand immediate repayment of
     any amounts utilized thereunder.
 -   I declare that I have received and read The Franchisors' Prospectus and is familiar with the contents.

3. I authorise the bank to disclose:
 -    any information relating to the conduct of my bank accounts held with the bank and/or my relationship with bank to any other division within the bank
     and/or any other member of the banks Group of Companies and/or any credit bureau or similar agency; and b) to the franchisor that my application for
     financing has been:
       i) approved and the terms and conditions applicable to such financing; or
           declined, and where it has been declined because of lack of, business viability, then I furthermore authorise the bank to disclose the specific reasons
       ii) therefore.




Signature of Applicant                                                                               Date:




Witness 1                                                                        Witness 2
ANNEXURE "B5" - CV Template
Personal Details

Full Name

State of Health

First Language

Other Languages

Drivers Licence
Personal Attributes

Goals and Objectives

Personal qualitites



Secondary Education

Last school attended

Year matriculated

Highest Std passed

Subjects

Leadership roles

Outstanding achievements



Post-Matric Qualitification

Institution attended

Courses / Degree completed

Year achieved



Current Employer

Name

Position held

Duties

Period
Previous Employer

Name

Position Held

Duties

Period

Reason for leaving



Previous Employer

Name

Position Held

Duties

Period

Reason for leaving
Previous Employer

Name

Position Held

Duties

Period

Reason for leaving


References

Name

Title

Employer

Contact Number



References

Name

Title

Employer

Contact Number



References

Name

Title

Employer

Contact Number



Please motivate below why you consider yourself as being likely to succeed in this business venture.
* Mark applicable option with X
SECTION B : PERSONAL APPLICATION
1. Personal Details - To be completed by each Shareholder & Surety if such Surety is not a Shareholde

Surname :                                                                                                               Title

First names :

Town and country of birth :

Nationality :                                                                          ID No :

Permanent SA Citizen :    YES          NO    E - mail address :

Tel No. (bus) :                                                                  Tel No. (home) :

Cellular :                                                                       Fax No :

Residential address

Period at present address :    Years              Months             Residential property is :      Owned          Rented

Postal address :



Drivers Licence :         YES          NO    Personal Income Tax No :

Number of dependants :                               Number of children                               Their ages

2. Marital Status

Single

Married                                COP                          ANC with Accrual                  ANC without Accrual

Divorced                      Was final divorce order granted ?      YES       NO       If yes, provide date of divorce decree :

Widowed(er)                                                                                             Widowed since :
(Include copy of Contract if married ANC, copy of divorce decree)

3. If married please supply the following additional information about your spouse

Surname :                                                                                                               Title

First names :

Town and country of birth :

Name of employer :

Employer's address :



Present position                                                                                 Annual income
4. Details of next of kin - 2 (not of the same address)

Initials and Surname :

Relationship :                                       Tel No :                                   Cellular :

Physical Address :



Initials and Surname :

Relationship :                                       Tel No :                                   Cellular :

Physical Address :



5. Employment history (from most recent)
Employer                                                        From              To           Last position held
                                                         M      M   Y    Y    M   M    Y   Y
 1
                                                         M      M   Y    Y    M   M    Y   Y
 2
                                                         M      M   Y    Y    M   M    Y   Y
 3
(Kindly include a CV - See annexure checklist)

6. Education

Highest secondary qualification :                 Year passed :                   School :

If you have a degree or diploma, please specify :

If you have completed a formal apprenticeships or pupilage, please specify :

If you have any other formal business skills, please specify :

7. Computer Literacy
If you have completed formal PC literacy courses, please indicate disciplines :                Excel     Word

If so, please attach certificate or confirmation of training provider.

Please provide full details of previous practical computer experience



8. Details of primary cheque / credit card / savings account
  Type of account         Bank / Institution                                 Account number                  Date opened
         Self
                                                                                                             M
 1 Cheque
                                                                                                             M
 2 Credit card
                                                                                                                        M
 3 Savings
       Spouse
                                                                                                                        M
 1 Cheque
                                                                                                                        M
 2 Credit card
                                                                                                                        M
 3 Savings


9. Credit record

Have you ever had any judgments against you (are you blacklisted)?          YES       NO      If YES, please provide details :




Have you ever been sequestrated?                                            YES       NO      If YES, please provide details :




If YES, have you been rehabilitated?                                        YES       NO      If YES, date rehabilitated :



Have you ever been found guilty of a criminal offence                       YES       NO      If YES, specify details




10. Previous business interests

If you had any previous active interest in any other business, please provide the following details:

Registered name:                                                                                                 Reg No :

Nature of business :
                         D    D    M    M    Y    Y
Date established :                                      Period involved :                                                Shareholding :

Reason for departure :



11. Current business interests
Business Interest 1

Registered Name of business                                                                                             Reg No.

Nature of business
Interest held in capacity as shareholder of :                          %         OR             Director / Managing Member

Interest Capacity:             Active           Silent     Discretionary        Other      Interest held since:

Value of Interest:          Capital       R                                   Annual Income     R
Business Interest 2

Registered Name of business                                                                               Reg No.

Nature of business

Interest held as:           Shareholder                   %     OR              Director / Managing Member

Interest Capacity:             Active           Silent     Discretionary        Other      Interest held since:

Value of Interest:          Capital       R                                   Annual Income     R
Business Interest 3

Registered Name of business                                                                               Reg No.

Nature of business

Interest held as:           Shareholder                   %     OR              Director / Managing Member

Interest Capacity:             Active           Silent     Discretionary        Other      Interest held since:

Value of Interest:          Capital       R                                   Annual Income     R




Signed at                                                                     on




Signature




Please e-mail to:
Or send to:                  Franchise Application Department
                             Postal address




                             or fax to:

Annexures to be attached to every individual application
(Please note: Should you have your own versions, please attach in place of the templates provided)

Personal Income & Expenditure statement.
Personal Assets & Liabilities.
Security offered
Application to include signed "Ackowledgement form"
Detailed curriculum vitae.
If Khula guarantee is required, latest personal SARS assessment is required.
Details/proof on the source of the financial (own)contribution of this shareholder to the venture
Copy of bank statements of shareholders personal accounts for the last 3 months
Documented proof of residential address as per FICA
Certified Copy of marriage certificate or divorce decree
Certified Copies of IDs

ANNEXURE "B1" - Personal Income & Expenditure of all prospective Shareholders
             Monthly income                             Self                     Spouse                                 Monthly expenditure

Gross salary                                 R                           R                          Bond repayment/Rent

Housing subsidy                              R                           R                          HP/Loan/Credit card

Car allowance                                R                           R                          Insurance (Life and sort-term)

Commission                                   R                           R                          Domestic (water, lights, rates)

Overtime                                     R                           R                          School and University fees

Other (specify)                              R                           R                          Transport

Other (specify)                              R                           R                          Maintenance (if divorced)

Other (specify)                              R                           R                          Subtotal (fixed expenses)

Other (specify)                              R                           R                          Other (specify)

Other (specify)                              R                           R                          Other (specify)

Other (specify)                              R                           R                          Other (specify)

TOTAL INCOME                                 R                           R                          Other (specify)

Less: Pension/Medical aid/PAYE               R                           R                          Other (specify)

NET INCOME                                   R                           R                          TOTAL EXPENSES

ANNEXURE "B2" - Statement of Assets and Liabilities
ASSETS
1. Fixed property registered in your name
City and Town property

Stand no                     City/Township       Purchase price         Date purchased         Fire insurance           Owner's valuation
                                                                                               R

                                                                                               R
Farm and Small holding property

Stand no/Name of farm   City/Township    Purchase price    Date purchased     Fire insurance       Owner's valuation

                                                                                               R

                                                                                               R
Property bought under deed of sale

Stand no/Name of farm   City/Township    Purchase price



2. Mortgage Bonds in own favour, i.e. where a bond is held over the fixed property of
another person. State first or subsequent bond(s) and give a description of property. State
the amount outstanding still receivable/Timeshare.                                                 Owner's valuation




3. Stock - specify




4. Vehicles (state the year, make and model)




5. Miscellaneous movable property




6. Debtors (state the names)




7. Shares and/or loans (specify)
   Listed on the JSE




  Unlisted shares/Loans to private companies
Other investments, assets and business interests (specify)




8. Life policies
 Insurance Company                    Policy number                       Life cover            Ceded to           Surrender value




9. Credit balances (e.g. savings accounts, fixed deposits, etc.)




TOTAL ASSETS


LIABILITIES (Amounts in Rand)
                             D    D    M   M    Y      Y
Liabilities stated as on:
1. Mortgage bonds (for amounts due under deed of sale)
Stand no/Name of farm         Town/City               Bondholder/Seller         Interest rate      Instalment           Expiry date




2. Term loans/personal loans (specify)


3. Owing under instalment sale agreements
  Type of asset e.g. vehicle, machinery, etc                  At which institution                         Instalments monthly




4. Income tax owing (state when due)
5. Owing to banks (state names and specify liabilities)




6. Owing in respect of credit cards (specify)




7. Other liabilities (describe and mention terms and conditions of repayment




TOTAL LIABILITIES
ASSETS LESS LIABILITIES
SURPLUS OF ASSETS OVER LIABILITIES
NOTARIAL BONDS (state over which assets and in favour of whom)




Contingent Liability

1. Property Leases
           Item                           Landlord                         Monthly Rental            Commencement Date




2. Suretyship
             In favour of                       At financial Institution               Details of security provided




ANNEXURE "B3" - Security offered
Description of security available
                                   Type of security                                      Available (x)          Value

First covering mortgage bonds - residential

Continuing covering mortgage bonds where another financial

institution or any other party holds prior ranking bonds.

NB: Consent of existing bondholder Essential.

Cession of listed shares on the JSE excluding any shares listed

in the Development Capital or Venture Capital sections of the JSE

Pledged Kruger Rands

Cession of fixed deposit

Cession of unit trust

Cession of life policy (Surrender value)

Other (specify)

1.

2.

3.


ANNEXURE "B4" - Acknowledgement Form
(*This section is to be completed by each Shareholder)


1. I ____________________________________________________ ID _______________________________warrant:
 -   that the information relating to my application provided in, Section B, of this application form dated __________________200__ , is
     the best of my knowledge and belief; and
 -   I have not misrepresented any facts or statements;
 -   that the statement of personal assets and liabilities is complete, true and correct and all liabilities have been fully disclosed.

2. I acknowledge:
 -   that the bank, in processing this application, may require to access information about myself, recorded with any third party, including
     credit bureaus and any financial institutions and I hereby consent to the bank accessing and/or obtaining this information; and
 -   that, save for the obligation set out in this declaration, this application does not constitute any binding agreement on the bank, to pro
     requested in this application. Should, however, the bank grant the financing requested, the bank will place reliance on the informatio
     and should it, at any stage, come to the fore that any information was incorrect, the the bank reserves the right, if it is prior to the fina
     provided, to withdraw such financing and if it is subsequent to the financing being provided, then to cancel such financing and to dem
     repayment of any amounts utilized thereunder.
 -   I declare that I have received and read The Franchisors' Prospectus and is familiar with the contents.

3. I authorise the bank to disclose:
 -    any information relating to the conduct of my bank accounts held with the bank and/or my relationship with bank to any other divisio
     and/or any other member of the banks Group of Companies and/or any credit bureau or similar agency; and b) to the franchisor that
     financing has been:
       i) approved and the terms and conditions applicable to such financing; or
           declined, and where it has been declined because of lack of, business viability, then I furthermore authorise the bank to disclos
       ii) reasons therefore.




Signature of Applicant                                                                           Date:




Witness 1                                                                     Witness 2


ANNEXURE "B5" - CV Template
Personal Details

Full Name

State of Health

First Language

Other Languages

Drivers Licence
Personal Attributes

Goals and Objectives

Personal qualitites



Secondary Education

Last school attended

Year matriculated

Highest Std passed

Subjects

Leadership roles

Outstanding achievements



Post-Matric Qualitification

Institution attended
Courses / Degree completed

Year achieved



Current Employer

Name

Position held

Duties

Period                       to date
Previous Employer

Name

Position Held

Duties

Period

Reason for leaving



Previous Employer

Name

Position Held

Duties

Period

Reason for leaving

Previous Employer

Name

Position Held

Duties

Period

Reason for leaving


References

Name
Title

Employer

Contact Number



References

Name

Title

Employer

Contact Number



References

Name

Title

Employer

Contact Number



Please motivate below why you consider yourself as being likely to succeed in this business venture.




home
urety is not a Shareholder

               Title



                          Gender           M             F




         Rented        by       Self               Spouse



                            Code




C without Accrual                      Tribal
                            D      D   M       M     Y       Y
 te of divorce decree :
                            D      D   M       M     Y       Y
Widowed since :



 r spouse

               Title



                          Gender           M             F




                            Code
                       Code




                       Code



st position held              Annual income




             Outlook Access Explorer    Other




          Date opened          Credit Limit

              M    Y   Y

              M    Y   Y
                 M    Y   Y



                 M    Y   Y

                 M    Y   Y

                 M    Y   Y




e provide details :




e provide details :




                          D   D   M   M   Y   Y
ehabilitated :



y details




             Shareholding :                   %




            Reg No.
Director / Managing Member             YES       NO
                       D      D    M     M   Y        Y
est held since:

R



          Reg No.



ng Member                    YES             NO
                       D      D    M     M   Y        Y
est held since:

R



          Reg No.



ng Member                    YES             NO
                       D      D    M     M   Y        Y
est held since:

R




d)                  Yes           No    Annexure
                                             B1
                                         B2
                                         B3
                                         B4
                                         B5




reholders
           Monthly expenditure

ayment/Rent                      R

Credit card                      R

e (Life and sort-term)           R

 (water, lights, rates)          R

nd University fees               R

                                 R

nce (if divorced)                R

 fixed expenses)                 R

                                 R

                                 R

                                 R

                                 R

                                 R

XPENSES                          R




           Owner's valuation         Bank use
R

R


    Owner's valuation   Bank use

R

R




    Owner's valuation   Bank use
        Surrender value




                           Amount Due




             Expiry date




Instalments monthly
mmencement Date       Term




                  Amount
                     Owned              Bank use




______warrant:
_________________200__ , is true and correct to



ve been fully disclosed.



ed with any third party, including but not limited to,
ining this information; and
g agreement on the bank, to provide the financing
  place reliance on the information provided herein,
 s the right, if it is prior to the finance being
 ancel such financing and to demand immediate


.
 ip with bank to any other division within the bank
ncy; and b) to the franchisor that my application for


re authorise the bank to disclose the specific
ure.
SECTION C - FINANCE APPLICATION
1. Extended business detail

Trading name:

Registered name                                                                                      Reg No.

Tel No.                                                                    Fax No.

Physical Business Address

                                                                                                                 Code

Postal address

                                                                                                                 Code

The registered office

                                                                                                                 Code

Name of the accounting officer / auditor

Contact Person

Email Address

Tel No.                                                                    Cell No.
2. Statutory Registration numbers

Income tax                                                          RSC levies

PAYE                                                                UIF

VAT                                                                 SDL
3. Industry
Telecommmunications                        Information technology                           Retail
Automotive                                 Manufacturing                                    Tourism
Contract services                          Mining                                           Transportation
Construction                               Professional services                            Wholesale - distribution
Heavy machinery- Plant                     Restaurant - Fast food                           Other

4.Details of leased premises

Landlord

Postal address                                                                                                   Code

Contact person                                                                        Cell No.

Tel no                                                                                Fax no.

Email address                                                                                           Escalation p.a.                     %

Initial monthly rental (ex.vat)      R                                 Monthly operating costs (ex.vat)      R
                                                                                                                       D   D   M   M    Y   Y
Area (m²)                                                                 Commencement date of lease

Lease Deposit     R                           Landlord contribution       R                             Term (months)
5. Other Sources of interest bearing loans
Has any other finance been applied for ?       YES        NO               If YES, specify details and the success of the application
Borrowed from                     Balance outstanding    Terms        Rate of interst    Monthly payment               Security given
6. Other information - in the case of an existing business
Has the business ever reached a compromise with debtors. If so please provide full details per annexure.          Yes    No
7. Customer and supplier references
               Name                          Relationship                   Contact person                   Tel No.




SECTION C - ANNEXURE - Checklist of Documents to be attached
(Please note: Should you have your own versions, please attach in place of the templates provided)     Yes   No    Annexure
Application to include signed "Declaration by Company or CC form" (See attached)                                     C1
Business Plan compiled per FFC / Franchisor template                                                                 C2
Letter from Franchisor stating that it has approved the applicant in terms of its usual requirements
Copy of signed Provisional Agreement
Copy of CK1 and CK2 (for CC's) or Certificate of Incorporation for companies
Full details of compromise reached, if appliccable.
ANNEXURE "C1" - Declaration Company or Close Corporation
(*This section to be completed if the franchisee is a Company or Close Corporation already formed)


I, the undersigned, in my capacity as _____________, the Company or the CC, whichever the case may be, hereby
warrant my authority in terms of a resolution passed by the board of directors or the members, whichever the case may
be on the      __and with my signature hereto, do hereby bind the Company or the CC , whichever the case may be, and
confirm that:
            a) the information provided in the business information section is correct and that the facts have not been
               misrepresented;
            b) the Company or the CC whichever the case may be, consents to the bank accessing any information
               pertaining to the Company or the CC, whichever the case may be, recorded with any third party, including
               but not limited to information with any financial institution;
           c) save for the obligations set out in this declaration, this application does not constitute any binding
              agreement on the bank to provide the financing requested by the Companyor the CC , whichever the case
              may be, provided however, that should the bank grant the financing requested, the bank will place full
              reliance on all information completed in terms of this application, whether or not on behalf of the Company
              or the CC , whichever the case may be, or otherwise, and should the bank grant the financing requested,
              the bank will place on the information provided herein and should it at any stage come to the fore that any
              information was incorrect then the bank reserves the right, if it is prior to the financing being provided, to
              withdraw such financing, and if it is subsequent to the financing being provided, then to cancel such
              financing and to demand immediate repayment of the amounts utilised there under;
           d) the Company or the CC , whichever the case may be, authorizes the bank to disclose any information
              relating to the conduct of the Company or the CC , whichever the case may be, bank accounts held with
              the bank, and/or its relationship with the bank to any other division within the bank and/or any other
              member of the banks Group of Companies and to the franchisor should the the Company or the CC ,
              whichever the case may be, application be successful or should it be declined, and if it is declined for
              reasons relating to a lack of business viability then the Company or the CC , whichever the case may be,
              the shareholders/members bank whichever the specific reasons therefore.
              furthermore consents to the{delete disclosing is not applicable} have received and have agreed to the contents of
           e) the disclosure document and are prepared to enter into a franchise agreement on the conditions currently stated
              therein.
           f) I authorize the financial institution to disclose full particulars regarding the approval or decline of my
              application to the franchisor.


Name : ___________________________________________________________


For and on behalf of _________________________________________________ the Company or the CC, whichever the case may be


     Signature ____________________________________________________               Date ______________________________
ANNEXURE "C2" - Business Plan Criteria

Contents                      1.          Executive summary
                              2.          Business Description
                              3.          Product Definition
                              4.          Market Definition
                              5.          Marketing Strategy
                              6.          Competition
                              7.          Operations & Management
                              8.          Financial Components

  1. Executive summary
             •What are the short & long term goals of the business

  2. Business Description
            •Reason for choosing these particular premises
            •What zoning is allocated to the business address

  3. Product Definition
    •What is the product mix of the business
    •What gives your product the competitive edge over the rivals in your area

  4. Market Definition
    •Who is your target market (age, income, etc)
    •What growth patterns can you see emerging with regard to the make-up and size of your market
            (expansion geographically, new customers, etc)

  5. Marketing Strategy
    •Provide a clear indication as to what your marketing strategy is going to be, over and above the involvement
             from the Franchisor

  6. Competition
    •Identify and list the major competitors in your area (use table below as guideline)

              Name           How long have they been in business          Products / Services provided

    •What key success factors do the competition demonstrate
    •Can you identify any weakness in the competitions business operations
    •What skills will be necessary in order to allow you to have the competitive advantage in your area

  7. Operations & Management
    •Do you foresee any industry changes occurring that will affect the way your business operates and how will
             these changes impact your business
•Who are the players in your business responsible for key areas such as: Marketing, Purchasing, HR Management, Accounting
    •Give us a brief overview on the staffing requirement of your business:(Organogram)
               ≈Management         ≈Staff

  8. Financial Components
    •Existing business:
             ≈Latest available Audited Financial Statements
                            ≈Updated Management Accounts
    •New business:
                            ≈Projected cashflow with a minimum term of 36 months
                            ≈Set Up costs
                                 ≈Detailed list of equipment
SECTION D - Documents that need to be submitted in order to effect payment
Draft copy of the Franchise Agreement
Draft copy of the Lease Agreement
Confirmation of Insurance Cover
If Khula guarantee required, resignation letter of owner must be attached

Confirmation of business banking details
Bank                                         Account number
Branch                                       Branch code
Contact person - RM                                         Tel No.
Overdraft limit                              Other facilities
Security

Franchisor Accreditation Pack
Disclosure Document from the franchisor
Index page of the franchise training manual & operations manual
Any other key documents related to management practise of the Franchise system


Existing business
Confirmation from the banks where business account was held previously that such account has been closed

								
To top