ANNEXURE PROSPECTIVE FRANCHISEE INITIAL APPLICATION FORM. Application Form Nando s Page 1

Transcription

1 ANNEXURE PROSPECTIVE FRANCHISEE INITIAL APPLICATION FORM Nando s Page 1

2 SECTION A NEW NANDO S BUSINESS DETAIL Managed by whom (Full-time) Complete Section B1 Date available for training: Geographical preference Do you intend involving a partner? Yes No If yes, such a person must also complete an application form. Name of partner/s Each partner to complete Section B2 individually If yes, state approximate shareholding Self % Partner Name % Note: Both parties must complete Section C Section F and both parties must sign the. Nando s Page 2

3 SECTION B1 PERSONAL DETAILS OF THE MANAGING OWNER/OPERATING PARTNER Note: 1. This section is to be completed by the individual who will be responsible for the day-to-day management of the franchised store. 2. Please attach a copy of your I.D. Document as well as a recent photograph of yourself together with your up-to-date Curriculum Vitae. 3. Nando s policy dictates that the Managing Owner must hold a minimum of 30% shares in the trading entity. Surname First names Place of birth Nationality Date of birth ID Number Residential address Code Postal address Code Telephone (Business) Telephone (Home) Cell address Permanent SA Citizen Yes No Fax no At present address Years Months Residential Property is Owned Rented Marital Status Single Y N If Married In community of property If divorced Final Yes No Date Final If widow/er (Include copy of Contract if married ANC, copy of divorce decree) Out of community of property Other If married please supply the following additional information about your spouse First names Place of birth Date of birth Name of employer Employer address Employers telephone Present position ID Number Nationality Annual Income Number of dependents Number of children Their ages ANC without Accrual Code Does your spouse understand the business risks and potential rewards involved? Yes No Do your spouse and family understand the extra demands that a new business will make in relation to your time and effort, especially in the establishment phase of the business? Yes No Nando s Page 3

4 Employment history Employer From To Type of work Last position held Annual income (Kindly include a CV) Education Highest standard passed. Do you have a degree or diploma Formal apprenticeships or pupilage? Do you have any formal business skills? Year If YES, specify If YES, specify If YES, specify Medical information Being the owner of a Nando s Franchise involves manual and mental pressures. Please provide the following information to assist us in ensuring that you are capable of meeting such requirements. What is your general state of health? Excellent Very Good Good Poor Is there any additional information regarding your general state of health that may impact on your ability to be a Nando s Franchisee? If yes, please give details. Details of next of kin Name and residential address of next of kin (not of the same address) Relationship: Name Telephone Code Nando s Page 4

5 Details of primary cheque/credit card/savings account Type of account Bank/Institution Account Number Date Opened Limits Self 1. Cheque 2. Credit card 3. Savings Spouse 1. Cheque 2. Credit Card 3. Savings Current accounts (If none, recently settled accounts) Institution/Business Branch Account Number Balance Present limit Credit record Have you ever had any judgments against you (are you blacklisted)? Yes No If YES, specify details Have you ever been sequestrated? Yes No If YES, specify details Have you ever been found guilty of a criminal offence Yes No If YES, specify details Date Nando s Page 5

6 Statement of Assets and Liabilities ASSETS (Amount in Rand) (A) 1. Fixed Property registered in your name City and Town property Owners Valuation Bank Use Erf no City/Township Purchase Price Date Purchased Fire Insurance Farm and Smallholding property Owners Valuations Bank Use Erf no Name of farm City/Township Purchase Price Date Purchased Fire Insurance Property bought under deed of sale Erf no Name of farm City/Township Purchase Price 2. Mortgage Bonds in own favor, 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. 3. Stock (specify) 4. Vehicles (State the model and year) 5. Miscellaneous movable property (specify) 6. Debtors (state the name) 7. Shares/Loans (specify) Listed on the JSE Unlisted shares/loans to private companies 8. Other investments and assets (specify) Nando s Page 6

7 9. Life policies (surrender values, if known) Insurance Company Policy number Life cover Ceded to Surrender Value 10. Credit balances (e.g. savings accounts, fixed deposits, etc.) TOTAL ASSETS (A) Liabilities (Amounts in Rand) (B) Liabilities stated as on 1. Mortgage bonds (for amounts due under deed of sale) Erf no/ Name of farm Town/City Bondholder/Seller Interest Rate Installment Expiry date Amount 2. Term loans, personal loans (specify) Sub Total 3. Owing under installment sale agreements Type of asset e.g. vehicle, machinery, etc At which institution Installments 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 (B) VALUE A B NOTARIAL BONDS (state over which assets and in favor of whom) Nando s Page 7

8 CONTINGENT LIABILITY 1. Leases Item Financed by Outstanding amount Installment Date payable 2. Suretyship In Favor At Financial Institution Details of security provided Amount Monthly income Self Spouse Monthly Expenditure Gross salary R R Bond repayments/rent R Housing subsidy R R HP/Loan/Credit Card R Car allowance R R Insurance (Life and Short term) R Commission R R Domestic (water, lights, rates) R Overtime R R School and University Fees R Other (specify) R R Transport R Other (specify) R R Maintenance (if divorced) R Other (specify) R R Subtotal (fixed expenses) R Other (specify) R R Other (specify) R Other (specify) R R Other (specify) R Other (specify) R R Other (specify) R TOTAL INCOME R R Other (specify) R Less: Pension/Medical R R Other (specify) R aid/paye NET INCOME R R TOTAL EXPENSES R Description of security Type of security First covering mortgage bonds residential Continuing covering mortgage bonds where another financial intuition 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) Available (x) Value Owned Bank Use Nando s Page 8

9 References Note: By your signature to this form, you are authorizing Nando s to perform whatever credit checks they may consider necessary in their assessment of the application. Bankers Branch Telephone No. ( ) Contact Person/Manager Account No. Other references: 1. Name Telephone No ( ) 2. Name Telephone No ( ) 3. Name Telephone No. ( ) 4. Name Telephone No. ( ) 5. Name Telephone No. ( ) 6. Name Telephone No. ( ) Date Name Signed by: Managing owner/operating partner Nando s Page 9

10 SECTION B2 DETAILS OF OTHER STAKE HOLDERS Note: 1. A copy of this section must be made for all partners, members or shareholders (who are not the Managing Owner of the business) and fully completed by each party. 2. Please attach a copy of your I.D. Document and a recent photograph of yourself. In what capacity is this section being completed? (tick one or more blocks as applicable) Fully active partner/member/shareholder Partially active partner/member/shareholder Investor Surname First names Place of birth Nationality Date of birth ID Number Residential address Code Postal address Code Telephone (Business) Telephone (Home) Cell address Permanent SA Citizen Fax no At present address Years Months Residential Property is Owned Rented Marital Status Single Y N If Married In community of property If divorced Final Yes No Date Final If widow/er Other (Include copy of Contract if married ANC, copy of divorce decree) Out of community of property If married please supply the following additional information about your spouse First names Place of birth Date of birth Name of employer Employer address Employers telephone Present position ID Number Nationality Annual Income Number of dependents Number of children Their ages Code ANC without Accrual Nando s Page 10

11 Does your spouse understand the business risks and potential rewards involved? Yes No Do your spouse and family understand the extra demands that a new business will make Yes No in relation to your time and effort, especially in the establishment phase of the business? Medical information Being the owner of a Nando s Franchise involves manual and mental pressures. Please provide the following information to assist us in ensuring that you are capable of meeting such requirements. What is your general state of health? Excellent Very Good Good Poor Is there any additional information regarding your general state of health that may impact on your ability to be a Nando s Franchisee? If yes, please give details. Details of next of kin Name and residential address of next of kin (not of the same address) Relationship: Name Telephone Code Employment history Employer From To Type of work Last position held Annual income (Kindly include a CV) Education Highest standard passed Do you have a degree or diploma Formal apprenticeships of pupilage? Do you have any formal business skills? Year If YES, specify If YES, specify If YES, specify Details of primary cheque/credit card/savings account Type of account Bank/Institution Account Number Date Opened Limits Self 1. Cheque 2. Credit card Nando s Page 11

12 3. Savings Spouse 1. Cheque 2. Credit Card 3. Savings Current accounts (If none, recently settled accounts) Institution/Business Branch Account Number Balance Present limit Credit record Have you ever had any judgments against you (are you blacklisted)? Yes No If YES, specify details Have you ever been sequestrated? Yes No If YES, specify details Have you ever been found guilty of a criminal offence Yes No If YES, specify details Date Statement of Assets and Liabilities ASSETS (Amount in Rand) (A) 1. Fixed Property registered in your name City and Town property Owners Valuation Bank Use Erf no City/Township Purchase Price Date Purchased Fire Insurance Farm and Smallholding property Owners Valuations Bank Use Erf no Name of farm City/Township Purchase Price Date Purchased Fire Insurance Property bought under deed of sale Erf no Name of farm City/Township Purchase Price 2. Mortgage Bonds in own favor, 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. 3. Stock (specify) Nando s Page 12

13 4. Vehicles (State the model and year) 5. Miscellaneous movable property (specify) 6. Debtors (state the name) 7. Shares/Loans (specify) Listed on the JSE Unlisted shares/loans to private companies 8. Other investments and assets (specify) 9. Life policies (surrender values, if known) Insurance Company Policy number Life cover Ceded to Surrender Value 10. Credit balances (e.g. savings accounts, fixed deposits, etc.) TOTAL ASSETS (A) Liabilities (Amounts in Rand) (B) Liabilities stated as on 1. Mortgage bonds (for amounts due under deed of sale) Erf no/ Name of farm Town/City Bondholder/Seller Interest Rate Installment Expiry date Amount 2. Term loans, personal loans (specify) Sub Total 3. Owing under installment sale agreements Type of asset e.g. vehicle, machinery, etc At which institution Installments Monthly Nando s Page 13

14 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 (B) NET ASSET VALUE (A B ) NOTARIAL BONDS (state over which assets and in favor of whom) CONTINGENT LIABILITY 1. Leases Item Financed by Outstanding amount Installment Date payable 2. Suretyship In Favor At Financial Institution Details of security provided Amount Monthly income Self Spouse Monthly Expenditure Gross salary R R Bond repayments/rent R Housing subsidy R R HP/Loan/Credit Card R Car allowance R R Insurance (Life and Short term) R Commission R R Domestic (water, lights, rates) R Overtime R R School and University Fees R Other (specify) R R Transport R Other (specify) R R Maintenance (if divorced) R Other (specify) R R Subtotal (fixed expenses) R Other (specify) R R Other (specify) R Other (specify) R R Other (specify) R Other (specify) R R Other (specify) R TOTAL INCOME R R Other (specify) R Less: Pension/Medical R R Other (specify) R aid/paye NET INCOME CC DRAWINGS R TOTAL EXPENSES R Nando s Page 14

15 Description of security Type of security Available (x) Value Owned Bank Use First covering mortgage bonds residential Continuing covering mortgage bonds where another financial intuition 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) Nando s Page 15

16 References Note: By your signature to this form, you are authorizing Nando s to perform whatever credit checks they may consider necessary in their assessment of the application. Bankers Branch Telephone No. ( ) Contact Person/Manager Account No. Other references: 1. Name Telephone No ( ) 2. Name Telephone No ( ) 3. Name Telephone No. ( ) 4. Name Telephone No. ( ) 5. Name Telephone No. ( ) 6. Name Telephone No. ( ) Date Name Signed by: Other shareholder Nando s Page 16

17 SECTION C General proposal overview Note: With all the shareholders having discussed the questions below, please insert your agreed response Why have you selected Nando s as a business opportunity and not any other franchise business? From your limited knowledge of the system, please give us your overview of the positive and negative aspects of the Nando s brand and system as you see it. What research have you undertaken? What was the outcome of your own investigation of the Nando s brand? Have you contacted any existing franchisees for input? If not, please specify why and if you have done so, what was the outcome of your discussions? How would you interpret the business risk associated with this proposal bearing in mind the information contained herein? Nando s Page 17

18 SECTION D DECLARATION & DISCLAIMER Do you or have you ever had any interest in any other business Yes No If YES, please supply the following details: Name of business : Nature of business: Period of existence: Intended Financing Means R Source (and contact at Bank, if applicable) Own cash Partners cash contribution Do you apply for a business loan? Yes No Please attach a copy of your ID document with this application (this applies to owner manager and All investors) I submit the following information as a complete and true personal record at the time of the date shown below. I understand that Chickenland (Pty) Ltd is relying upon all the above information as a material factor in considering my application to become a franchisee of their group and therefore agree to promptly notify Nando s of any material change in any of the above information or any subsequent information provided by Nando s. Furthermore, by your signature to this application, Chickenland (Pty) Ltd and/or their duly appointed representatives are authorised to perform whatever credit checks they consider necessary in the assessment of the application. The undersigned certify that the information provided is true and correct. Nando s Page 18

19 I declare that I have received and read Nando s brochure I acknowledge the fact that this application does not bind or obligate any party in any manner. Signed at on this day of 200 _ WITNESSES: Signature of Owner/Manager Signed at on this day of 200 _ WITNESSES: Signature of other Shareholder/s Please to: Or send to: fr-apps@nandocas.com Nando s P.O. Box Troyville 2139 Or fax to Nando s Page 19

20 SECTION E BUSINESS LOAN 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 myself at a financial institution of my own choice Yes No I request Nando s for guidance to which financial institution this application must be Yes No forwarded If yes, then you must sign the acknowledgement and consent hereunder Yes No If any of the finance options is applied for, the approval or refusal of the application is within the sole discretion of the financial institution. This financial institution will provide you with a facility letter or letter of approval setting forth the full details of the financing granted, security to be furnished, cost involved and related matters. Nando s Page 20

21 ACKNOWLEDGEMENT AND CONSENT BY APPLICANT (This consent is required in terms of the Code of Banking Practice relating to obtaining written consent for verification of information provided for during the lending assessment process). I hereby irrevocably: Authorize the financial institution selected by Nando s to contact any of the referees (including but not limited to banks or auditors), mentioned in this application form and to obtain any additional information which the financial institution, in it sole discretion, may deem necessary; I hereby declare the information provided in this application form 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 myself (either personally or on behalf of any CC or Company) or myself and the financial institution, null and void. I herewith declare that the amount as stated in the application as own contribution has not been borrowed from any source where it is repayable in the future or where it may cause any financial liability to the business. I further acknowledge that this application does not constitute any form of agreement or contract whatsoever between the franchisor, the financial institution and myself, and is no way binding on either party. However, if any finance is granted to me as a result of this application, the information contained herein will throughout the duration thereof form the basis for such financing. I authorize the financial institution to disclose full particulars regarding the approval of my application to Nando s. Signed at on this day of 200 _ WITNESSES: APPLICANT Nando s Page 21