Franchise Loan Application by jbl53548

VIEWS: 16 PAGES: 4

More Info
									                                                         FRANCHISE / LOAN APPLICATION
                                                                                 CONFIDENTIAL



                                                                        Is Pleased To Offer Financing For

Thank you for taking the time to complete this application. You may have previously filled out a Request for Consideration, however, you need to
complete this more detailed form using the most current information. This is especially important if your situation has changed since you filled out
the Request for Consideration. This information will be used to determine your ability to properly fund your new ServiceMaster Clean business.
We will also use this information in considering the type of financing arrangements that we may be able to provide.

                                                     PERSONAL AND BUSINESS INFORMATION
Applicant's Name______________________________________________________ Birthdate                       Soc. Sec. #
Home Address____________________________________County__________             City, State, Zip____________________________________
Home Phone__________________________ # of Dependents ___ E-Mail Address________________________________________________
Occupation_________________________     Employer______________________________How Long              Bus. Phone
Education: High School         Some College    College Graduate Degree_______________________ From
Name of closest relative not living with you                        Relationship                       Phone
Address                                                             City, State, Zip


     * Complete this section only if (a) this is a joint account with your spouse, (b) your spouse will use your account, ( c) you are relying on your spouse's income as a source of repayment of the
                 credit, or you live in a community property state (AZ, CA, ID, LA, NV, NM, TX, WA, or WI). A non-spouse co-applicant is required to fill out a separate application.


Spouse's Name______________________________________________________    Birthdate                       Soc. Sec. #
Home Address____________________________________County__________             City, State, Zip____________________________________
Home Phone__________________________ # of Dependents ___ E-Mail Address________________________________________________
Occupation_________________________     Employer______________________________How Long              Bus. Phone
Education: High School         Some College    College Graduate Degree_______________________ From
Name of closest relative not living with you                        Relationship                       Phone
Address                                                             City, State, Zip

                                                                       FINANCIAL INFORMATION
Do you intend to devote full time to the franchise?  Yes _______ No _______         Will spouse be involved? Yes _______ No _______
Will either you or your spouse continue working in a business other than this franchise? You? y/n ______ Spouse? y/n ______
If you own or have ever owned a business or a franchise, please give details.____________________________________________________
_____________________________________________________________________________________________________________________
Which franchise license? Janitorial___ Disaster Restoration___ Residential___ Commercial___ Small Market___ Other____
When would you like to start your franchise business?______________________________________________________________________
What legal structure will your business be? Sole Proprietorship _____ Partnership _____ Corporation _____ LLC_____ LLP ______
If you are using retirement funds, when are they available?__________________________________________________________________
Who is distributing the funds?_________________________________________________________________         Amount?_________________
                                                                           Penalties?____________________________________________
Are these funds subject to taxation upon withdrawal?____________________________________

Please identify your SOURCES AND AMOUNTS
      of working capital for the business startup.                                         A. INITIAL FRANCHISE FEE                                                           A.

                SOURCES                               AMOUNT                               B. PRODUCTS/EQUIPMENT                                                              B.
                Checking                                                                       PLUS ADDITIONAL ITEMS
                Savings
                Stocks                                                                     C. TOTAL (A and B)                                                                 C.
                Investments
                Retirement                                                                 D. DOWN PAYMENT                                                                    D.
                Home Equity                                                                (At least 20% of the initial franchise fee, products,
                Bank Loan                                                                  equipment plus additional items.)
                Relatives
                Other                                                                      E. TOTAL LOAN FINANCING REQUESTED                                                  E.
                                 TOTAL                                                     (No more than 80% of the initial franchise fee,
                                                                                           products, equipment plus additional items.)                                    (TOTAL of C minus D)

                                                                             VEHICLE INFORMATION
If you plan to acquire a vehicle through SMAC will you:
         Purchase and finance through SMAC? Yes ______ No ______
           Purchase through SMAC (no SMAC financing requested)? Yes ______ No ______
Vehicles available: 1/2 Ton Van _____                       1 Ton Van _____              Box Truck_____               Pick-up_____
Specific information on available vans will be sent to you upon approval of financing.
US-SVM-IO-REV 0406
                            COMPLETE SCHEDULES A THROUGH F ON FOLLOWING PAGE FIRST
                                                        ASSETS                                                                                                            LIABILITIES

   CURRENT ASSETS                                                                             (In even dollars)                 CURRENT LIABILITIES                                                    (In even dollars)


CASH - Schedule A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                      NOTES PAYABLE - Schedule E . . . . . . . . . . . . .


STOCKS & BONDS - Schedule B                           .....................                                                  INSTAL & CHG ACCTS - Schedule F . . . . . . . .


NOTES RECEIVABLE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                             TAXES PAYABLE (Type):


CASH VALUE/LIFE INS - Schedule C                            .................                                                LOANS ON LIFE INS POLICIES - Schedule C . .


OTHER CURRENT ASSETS - Itemize:                                                                                              OTHER CURRENT LIABILITIES - Itemize: . . . . .




   OTHER ASSETS                                                                                                                 OTHER LIABILITIES

REAL ESTATE OWNED - Schedule D                                ................                                               MORTGAGES PAYABLE - Schedule D . . . . . .


PERSONAL PROPERTY & FURNITURE                                        ............                                            OTHER LONG TERM DEBT - Itemize: . . . . .


AUTOMOBILE / Year & Make:




OTHER ASSETS - Itemize:


                                                                                                                             TOTAL ALL LIABILITIES . . . . . . . . . . . . . . . . . . . . .


                                                                                                                             PRESENT NET WORTH:
                                                                                                                             (Total Assets LESS Total Liabilities) . . . . . . . . . . . . .

TOTAL ASSETS                     .................................                                                           TOTAL LIABILITIES + NET WORTH

                           SOURCE OF INCOME (Annual)                                                                                                CONTINGENT LIABILITIES
(Alimony, child support or separate maintenance                                                                              If you answer "yes" to any questions below, please provide an explanation in COMMENTS

income need not be revealed if you do not wish to                                                                            on page three.

have it considered as a basis for paying this obligation.)                                  APPLICANT         SPOUSE                                              . ......
                                                                                                                             Are you an Endorser or Co-maker on any. Notes? . . . . . . . .           No   Yes       Amt.

                                                                                                                             Are you defendant in any legal action? . . . . . . . . . . . . . . . .   No   Yes       Amt.
          .
BASE SALARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
                                                                                                                             Other contingent Liabilities - Itemize         ................

BONUS & COMMISSIONS                        ...........................


DIVIDENDS & INTEREST . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                                                                                  OTHER
                                                                                                                                                                    ... ....
                                                                                                                             Are there any unsatisfied judgments against. you? . . . . . . . .        No   Yes       Amt.
REAL ESTATE INCOME (net)                         ........................
                                                                                                                             Have you ever filed bankruptcy?       ................                   No   Yes       Amt.
OTHER INCOME - Itemize . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                               (Please explain. Show chapter and date filed.)



                                                                                                                                                                      ..
                                                                                                                             Have you ever been convicted of a felony?. . . . . . . . . . . . . .     No   Yes
                                                                                                                             (Please explain and list date of conviction.)




TOTAL ANNUAL INCOME                               .......................




                                                                                                                       APPLICANT NAME ________________________________________________________
US-SVM-IO-REV 0406                                                                                                     -2-
                                                                          COMPLETE THE FOLLOWING SCHEDULES IN DETAIL
                                                                                               Use Separate Sheets If Necessary

SCHEDULE A - Cash in Banks or Other Financial Institutions (Checking, Savings, Certificates)
TYPE OF ACCOUNT                       FINANCIAL INSTITUTION-Contact Name & Phone #                                          ACCOUNT #                                                      AMOUNT




                                                                                                                                                TOTAL $

SCHEDULE B - Stocks and Bonds
 No. of SHARES or                                                                            JOINTLY HELD?                            STOCK EXCHANGE
 Par Value of Bonds                          DESCRIPTION                                      Yes     No                              (NYSE, AMEX, OTC)                                      VALUE




                                                                                                                                                       TOTAL $

SCHEDULE C - Life Insurance                                                                                                                                                                  A-B=C

   FACE VALUE                          NAME OF COMPANY                             OWNER                         a) CASH VALUE                        b) LESS LOANS                       c) NET VALUE




                                                                                   TOTAL $
SCHEDULE D - Real Estate
                                                      PURCHASE                   MORTGAGE                          MORTGAGE                             MONTHLY                             PRESENT
       PROPERTY ADDRESS                               PRICE/YEAR                 COMPANY                           BALANCE                              PAYMENT                           MARKET VALUE




                                                                                   TOTAL $

SCHEDULE E - Notes Payable
                             PURPOSE DEBT ASSETS          DATE            INT                                                                           MONTHLY
          PAYEE                                                                    NUMBER OF PMTS. REMAINING
                                  PLEDGED
                                                       BORROWED          RATE                                       AMOUNT BORROWED                     PAYMENT                                      AMOUNT OWED




                                                                                   TOTAL $

SCHEDULE F - All Obligations to Third Parties, Installment, Charge Accounts & Other Payables
                             PURPOSE DEBT ASSETS          DATE            INT                                                                           MONTHLY
          PAYEE                                                                    NUMBER OF PMTS. REMAINING
                                  PLEDGED
                                                       INCURRED          RATE                                       AMOUNT BORROWED                     PAYMENT                                      AMOUNT OWED




                                                                                   TOTAL $

Comments:



 The information in this Application and other supporting documents (i.e. business financial statement, tax return, etc.) is provided to assist The ServiceMaster Acceptance Company L.P. (SMAC) in deciding whether to extend
 or to continue to extend credit to the undersigned or to others upon the guarantee of the undersigned. The undersigned acknowledge and understand that SMAC relies on the information provided in deciding to grant or to
 continue to extend credit or to accept a guarantee thereof. Each of the undersigned represents, warrants and certifies that the information provided is true, correct, and complete and agrees to notify SMAC
 immediately and in writing of any material change in (1) any information provided (2) the financial condition of any of the undersigned or (3) the ability of any of the undersigned to perform its (or their)
 obligation to SMAC. SMAC may make all inquiries that it deems necessary to verify the accuracy of the information provided and to determine the credit-worthiness of the undersigned. SMAC may obtain and use
 consumer credit information in considering the undersigned's eligibility to obtain credit from SMAC and for informational purposes should the undersigned default on the terms of the credit if it is extended to applicant. Such
 credit information shall include, but is not limited to, credit reports. If approved for financing, the undersigned acknowledges that SMAC may file a Uniform Commercial Code Financing Statement (Form UCC-1) with the
 appropriate jurisdictions to perfect a security interest in any collateral pledged. SMAC requires the applicant and co-applicant to execute any promissory notes that evidence indebtedness of the undersigned to SMAC to
 include a personal guarantee of repayment by applicant and co-applicant. SMAC may require the undersigned to absorb the cost of any title, filing, credit search or other miscellaneous charges related to this Application.
 This Application and any other information that the undersigned gives to SMAC shall be the property of SMAC. Thereafter, if credit is given, in the event any payment on the loan becomes delinquent, SMAC, its agents,
 successors, and assigns, may, in addition to all their other rights and remedies, report the account information to any credit reporting agency SMAC deems appropriate.

 Certification: The undersigned acknowledge and certify that credit extended to the undersigned or to others upon the guarantee of the undersigned by SMAC shall be solely for business purposes. The funds will not be
 used for personal or consumer purchases. The undersigned further acknowledge that any intentional or negligent misrepresentation(s) of the information contained in this Application may result in criminal penalties and/or
 civil liability which may be available to SMAC, its agents, successors, and assigns who may suffer any loss due to reliance upon any misrepresentation which the undersigned have made on this Application. The
 undersigned acknowledge that they have read, understand and agree to the terms stated above and consent to SMAC obtaining credit reports for the purposes listed above.




               Date_______________________________                                                              Signature of Applicant_________________________________________________



               Date_______________________________                                                              Signature of Spouse (If applicable)____________________________________


US-SVM-IO-REV 0406                                                                                                    -3-
                                   Background Check Release


In connection with my interest in investigating a ServiceMaster Clean franchise, I understand that investigative background
inquiries are to be made on myself including consumer, criminal, driving and other reports. This information will, in whole or
in part, be obtained from Acxiom Information Security Services (AISS), 6111 Oak Tree Blvd, 4th Floor, Independence, OH
44131, telephone 800-853-3228. These reports will include information as to my general reputation, character, mode of
living, work habits, performance and experience, along with reasons for termination of past employment from previous
employers. Further, I understand that you will be requesting information from various federal, state and other agencies
which maintain public and non-public records concerning my past activities relating to my driving, credit, civil, education and
other experiences.

I authorize without reservation, any party or agency contacted by the ServiceMaster Clean Home Office to furnish the above
mentioned information:

                                                                  /      /                             -        -
               Applicant Name                                 Date of Birth*                      Social Security Number


Alias/Maiden Name(s)


        Current Address                                               City & State                            Zip Code


        Driver's License #                        State                                Prospective Employer


Applicant's Signature                                                                           Date

*Date of Birth is being requested in order to obtain accurate retrieval of records.

           California, Minnesota and Oklahoma Applicants Only: Please check here to have a copy of your consumer
           report sent directly to you. Minnesota and Oklahoma applicants will receive a copy direct form AISS. California
           applicants may receive a copy from either the prospective employer or AISS.



Notice to California Applicants

Under Section 1786.22 of the California Civil Code, you have the right to request from AISS, upon proper identification, the
nature and substance of all information in its files on you, including the sources of information, and the recipients of any
reports on you which AISS has previously furnished within the two year period preceding your request. You may view the
file maintained on you by AISS during normal business hours. You may also obtain a copy of this file upon submitting
proper identification and paying the costs of duplication services. Upon making a written request, you may receive a
summary of your report via telephone.
                                                   Fax or mail to:
                                                    901-597-7580
                                                ServiceMaster Clean
                                                 Market Expansion
                                                3839 Forest Hill-Irene
                                                 Memphis, TN 38125
US-SVM-IO-REV 0406                                              -4-

								
To top