APPLICATION TO OPERATE A JOLLY MILLER FRANCHISE STORE

Transcription

1 APPLICATION TO OPERATE A JOLLY MILLER FRANCHISE STORE Applicant: CHECKLIST Step 1 (also see explanatory notes below) Please complete this file and return your Application by to the address in the contact information detailed below Step 2 You must also print, sign and send a hard copy enclosing ALL of the relevant supporting documents listed below. NOTE: Applicants are advised to provide as much information as possible with the intial application process. If supporting documentation is not provided during the application process, a Franchise Agreement cannot be completed, such delays may impact on other commercial arrangements, for example a Contract of sale. Non refundable Application Deposit of $2,000 Trust deed Partnership Agreement Company Constitution Copies of rates notices for all properties Copies of current bank statements, including mortgage accounts Insurance certificates for motor vehicles or personal effects Share certificates or statements of share portfolios Police check (visit for more information) Plus any other material that supports your application eg: business valuations, revenue, reports, asset register, balance sheets etc. MAIL TO: Head Office The Jolly Miller Technology Drive Sunshine West reception@thejollymiller.net.au

2 STORE DETAILS 1. PROPOSED STORE Store Address (street) Store Address (postal) FRANCHISEE DETAILS 2. FRANCHISEE NAME of Applicant ABN of Applicant ACN 3. FRANCHISEE STRUCTURE Please indicate the proposed structure of the franchisee. This could be: an individual or group of individuals; a company; a trust; or a partnership between a combination of these. If a partnership is being created, please explain the partnership structure in QN 4 and then complete the relevant section for each partner, otherwise skip to QN 5. Partnership Individual(s) Company Trust 4. PARTNERSHIP DETAILS List each individual, trust or company that forms part of the partnership % Owned Partner #1 % Partner #2 % Partner #3 % Partner #4 %

3 Please provide a copy of the Partnership Agreement

4 5. INDIVIDUAL DETAILS Partner #1 (No PO box accepted) Partner #2 (No PO box accepted) Partner #3 (No PO box accepted) Partner #4 (No PO box accepted)

5 6. COMPANY DETAILS Company Details Company Name ACN Company Address Please provide a copy of the articles of Incorporation and bylaws 7. DIRECTORS SHAREHOLDER S DETAILS Director/Shareholder #1 No. of Shares Owned Are you the beneficial owner of these shares? Yes No If no please complete details below Beneficial Owner

6 Director/Shareholder #2 No. of Shares Owned Are you the beneficial owner of these shares? Yes No If no please complete details below Beneficial Owner Director/Shareholder #3 No. of Shares Owned Are you the beneficial owner of these shares? Yes No If no please complete details below Beneficial Owner

7 Director/Shareholder #4 No. of Shares Owned Are you the beneficial owner of these shares? Yes No If no please complete details below Beneficial Owner 8. COMPANY STRUCTURE SUMMARY Please check that these details accurately reflect your company structure. If there are any unassigned shares insert here Name Number of Shares Percent of Shares Owned % % % % Unassigned Shares % Total %

8 9. TRUST DETAILS Name of Trust Type of Trust Unit Trust Discretionary Trust Unit Holder/Adult Beneficiaries Beneficiary #1 Beneficiary #2 Beneficiary #3

9 10. NOTICE OF GUARANTORS Jolly Miller will require all principal owners to provide guarantees to the Franchise Agreement. If you use a different address than that of your home address for such formal notices, what is that address. Guarantor #1 Phone Fax Guarantor #2 Phone Fax Guarantor #3 Phone Fax

10 PERSONAL INFORMATION A copy of this section to be completed by each person mentioned in QN CONTACT DETAILS Contact Name Contact Details Mobile Home Work Fax 12. EXISTING JOLLY MILLER FRANCHISEES Is the applicant an existing Jolly Miller franchisee? Yes No (go to QN 13) Details of Other Stores Operated by this Applicant Existing Franchisee Only 13. PERSONAL DETAILS Date of Birth Marital Status Married Defacto Unmarried Separated Name of Spouse/ Defacto/Partner No. of Dependants Age of Dependants Are you an Australian citizen? Yes No If No, state place of permanent residence and immigration status:

11 Have you ever owned a franchise or licensed business? Yes No Have you have any judgements, actions, law suits or civil, criminal or debt recovery proceedings been commenced against you or your business? Yes No Have you ever committed a crime, other than a minor traffic violation? Yes No Have you, or any business entity in which you ever owned an interest, been involved in any insolvency related proceedings Yes No Are you now, or have you or any member of your family ever been, associated with or employed by The Jolly Miller or its affiliates or franchisees? Yes No Are you, or any family member or employer, providing goods or services to The Jolly Miller? Yes No Are you now, or have you or any member of your family ever been, associated with or employed by The Jolly Miller or its affiliates or franchisees? Yes No Have you, or any member of your family, ever owned, managed or operated a food related business? Yes No Have you ever owned a franchise or licensed business? Yes No If yes to any of above, please provide details below Do you propose to work in this Jolly Miller Franchise store? Yes No If yes, how many hours per week? Does your partner propose to work in this Jolly Miller Franchise store? Yes No If yes, how many hours per week? If no to above, who will manage the store? Manager s Details Describe the Manager s Experience

12 14. FRANCHISEE BUSINESS EXPERIENCE (MOST RECENT) Current Business/Employment #1 Employed Self-Employed Company Name Company Address Position Duties & Responsibilities Staff Supervised Annual Income No. of years in position Reason for Leaving Current Business/Employment #2 Employed Self Employed Company Name Company Address Position Duties & Responsibilities Staff Supervised Annual Income No. of years in position

13 Reason for Leaving

14 Current Business/Employment #3 Employed Self Employed Company Name Company Address Position Duties & Responsibilities Staff Supervised Annual Income No. of years in position Reason for Leaving Current Business/Employment #4 Employed Self Employed Company Name Company Address Position Duties & Responsibilities Staff Supervised Annual Income No. of years in position Reason for Leaving

15 15. PERSONAL REFERENCES List three people who have known you for at least 2 years. Do not include employers, employees or relatives. Person #1 Address Phone Relationship Person #2 Address Phone Relationship Person #3 Address Phone Relationship

16 FINANCIAL INFORMATION A copy of this section to be completed by each person mentioned in QN ANNUAL INCOME & EXPENDITURES Applicant Spouse/Partner Total Annual Income from present occupation (business) after tax (include salary, wages, rent, investments, pensions, social security, etc.) Annual General Expenses (food, Clothing, electricity, gas, phone, maintenance, child support, insurance) Annual Mortgage/Rent Payments Transport Expenses Other Expenses (other loans, credit cards, superannuation, insurance, education, entertainment) Total Annual Expenses Surplus/Shortfall (income less expenses) 17. SAVINGS Savings Details Name of Bank Type of account Current balance 18. OUTSTANDING LOANS Debtor Loan Type Security Amount Owing

17 Total

18 19. SHARES & SECURITIES Total estimated current market value of all stock, shares and securities 20. OTHER ASSETS Current Value Motor Vehicles Personal effects (furniture, jewellery, paintings etc.) Other (please specify) Total Businesses or shares in businesses should be valued at asset value only (excludes any goodwill) and supporting documentation should be provided. 21. REAL ESTATE Property #1 Street Address Purchase price Date of Purchase Current market value Mortgage Balance Bank providing mortgage Name on title Use Principal Residence Secondary Residence Investment Property

19 Property #2 Street Address Purchase price Date of Purchase Current market value Mortgage Balance Bank providing mortgage Name on title Use Principal Residence Secondary Residence Investment Property Property #3 Street Address Purchase price Date of Purchase Current market value Mortgage Balance Bank providing mortgage Name on title Use Principal Residence Secondary Residence Investment Property

20 Property #4 Street Address Purchase price Date of Purchase Current market value Mortgage Balance Bank providing mortgage Name on title Use Principal Residence Secondary Residence Investment Property 22. LOANS PAYABLE Do not include mortgage details Lender Loan Type Security Amount Owing Total 23. CONTINGENT LIABILITIES Legal claims and judgements provision for income tax Other special debt on leases or contracts as endorser or guarantor

21 24. OTHER LIABILITIES Amount Owing Motor Vehicle Leases Hire Purchases, Leases etc. Accounts Payable Taxes and Assessments Payable Employment Entitlements Other (please specify) Total 25. PERSONAL FINANCIAL STATEMENT $ $ Savings Loans payable Loans receivable Contingent Liabilities Shares & securities Other Liabilities Other Assets Mortgage Real estate Total Assets Total Liabilities Total net worth

22 26. STORE FINANCE What is the startup capital / purchase price of the store $ Amount to be borrowed $ What security is the bank taking Mortgage on family home or other properties Charge over assets of business Other (please specify) Name of Bank providing loan Contact Name at Bank Contact Phone Number Address of Bank Street Address 27. LAWYER DETAILS Law Firm Contact Details Address Phone Fax

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24 28. ACCOUNTANT DETAILS Accounting Firm Contact Details Address Phone Fax NOTES Please type any additional notes that may assist your application

25 ACKNOWLEDGEMENT & RELEASE For (Applicant name): NOTE: If more than one individual/entity to the application, then to be completed separately by each individual /entity I Promise that everything I have stated in this application is true and correct and that i have not omitted any material information. I understand that: The grant of a franchise is at the sole discretion of The Jolly Miller. I understand that information provided by me in this application will be relied upon by The Jolly Miller. I understand that if my application is refused, the $2,000 payment I have made with this application is not refundable. My personal information is collected to assess my suitability to become a franchisee of The Jolly Miller and that my personal information may be disclosed to third parties, such as credit reporting, investigative and government agencies, to assist The Jolly Miller to make this assessment. I consent to such disclosure. I may contact The Jolly Miller to gain access to my personal information. If I do not disclose all personal information required, The Jolly Miller may refuse to grant a franchise to me. I authorise an investigative credit check and understand that it may contain information about my background, character, general reputation, mode of living, credit worthiness and job performance. I authorise all entities and agencies to release such information to The Jolly Miller in confidence and release them from liability for complying with this authorisation. I release The Jolly Miller and its affiliates, their officers, agents, employees and servants from any liability arising from the preparation of this report or investigation. I understand that any information I receive from The Jolly Miller or from any employee, agent or franchisee of The Jolly Miller is highly confidential, has been developed with a great deal of effort and expense to The Jolly Miller and is being made available to me because of this application. I promise to hold such information in strictest confidence. I promise not to divulge or use any data, customer or employee names and addresses, techniques, methods, advertising materials, forms or other information of whatever kind received from The Jolly Miller without its written consent. I understand that I may be required to successfully complete The Jolly Miller s training program. Applicant Signature Date Witness Signature Date Witness Date