For additional information regarding this application, please call extension 14 or send an to
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- Georgiana Blankenship
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1 Incredible Pizza Franchise Group, LLC (IPFG) REQUEST FOR CONSIDERATION TO BECOME A FRANCHISEE Thank you for your interest in Incredible Pizza Company. Please complete the following application Application Process As a prospective franchisee, please complete this franchise application and then we will set an appointment interview with our Franchise Representatives at Incredible Pizza Company in Springfield, Missouri. Application submitted by prospective franchisee All candidates and partners will submit a completed application be considered. Financial Approval IPFG evaluates each application ascertain a candidate s financial ability successfully capitalize an Incredible Pizza Family Entertainment Center ( IPFEC ). We will accept a pre-printed personal financial statement if you have a current one prepared. Please note (ALL APPLICANTS MUST FILL OUT OR PROVIDE THE FINANCIAL STATEMENT BEFORE BEING CONSIDERED)! Introducry Call Once approved, candidates will then receive an introducry call from Incredible Pizza Company detailing the basic information about franchising opportunities. In addition, you will receive a copy of the Incredible Pizza Franchise Group Franchise Disclosure Document ( FDD ). Detailed Call After a few days you will receive a call where all other questions may be addressed. When your questions have been answered, we will make arrangements with you schedule a one-day trip Incredible Pizza Company in Springfield, Missouri begin gain an understanding what is involved in owning an Incredible Pizza Family Entertainment Center Franchise. Candidates meet with representatives of the Franchise Operations discuss facility management, construction management, personnel, training requirements, development goals and objectives. Development Process Franchise Agreement Signed and Franchise Fee Paid Site Development Form Completed IPFG will make arrangements visit your site and decide if it is acceptable for an IPFEC Site Approved and Financing Secured If your site is approved, the next step is sign a Management Agreement, Project Consulting Agreement and pay the appropriate fees listed in the FDD that pertains these two agreements. Construction Begins Family Entertainment Center Approved Open Pre-opening parties Opening Day For additional information regarding this application, please call extension 14 or send an franchiseinfo@incrediblepizza.com. Incredible Pizza Company Family Entertainment Centers require a significant amount of capital build. All applicants must meet or exceed a minimum net worth requirement of $1.5 million ($1,500,000.00) and have liquid assets of $500,000. The cost build is much more than this; however there are SBA loans etc. that you may qualify for. IPFG Franchise Application Page 1of 6 APRIL 2009
2 APPLICATION FOR AN INCREDIBLE PIZZA FAMILY ENTERTAINMENT CENTER FRANCHISE Personal Data Full Name (Last) (Middle) (First) Primary Residence Address City State Zip Telephone no.: Residence ( ) Daytime (if different) ( ) If, the daytime phone no. is your work no., may we contact you at work? Y / N Driver s License No.: Date of birth Fax #: ( ) Country of Citizenship State: Marital status Name of Spouse (Last) (Middle) (First) Occupation of Spouse Length of employment Income Home: Own Rent Name & Phone no. of Landlord Length of occupancy Last former residence (if less five years at current address) Own Rent Length of occupancy Education: Degree or Last year of school completed Name of college Employment Background List employment hisry for the past ten years, beginning with the most current: (PLEASE ATTACH PERSONAL RESUME) Dates Company Name & Address Title Annual Income Current Business Affiliations other than occupation (owner, partner, officer, etc.) IPFG Franchise Application Page 2of 6 APRIL 2009
3 Company Data Company Name Federal ID No. (As shown on tax return fillings) Primary Address City State Zip Telephone no.: ( ) Fax #: ( ) Date of Incorporation State Incorporated In Name of Officer (1) Title: (Last) (First) (Middle) Name of Officer (2) Title: (Last) (First) (Middle) Please indicate the primary business of your company: Other Background Information Have you and/or any applicable partners, officers, direcrs, or shareholders within your business or personal affiliations ever: a) had any administrative, criminal, or civil action alleging a violation of any franchise law, fraud, embezzlement, fraudulent conversion, restraint of trade, unfair or deceptive practices, misappropriation of property, or comparable allegations? Y / N b) been convicted of a felony or pleaded nolo contendere a felony charge or been held liable in a civil action by final judgment or been the subject of a material complaint or other legal proceeding if such felony, civil action, complaint, fraud, embezzlement, fraudulent conversion, restraint of trade, unfair or deceptive practices, misappropriation of property, or comparable allegations? Y / N c) been adjudged bankrupt or reorganized due insolvency? Y / N If yes any of the above three, please explain IPFG Franchise Application Page 3of 6 APRIL 2009
4 Franchise Information Location preferences: 1st 2nd 3rd 4rd Size Concept Desired: 90,000 60,000 Sq Ft 60,000 40,000 Sq, Ft. 40,000 20, Sq. Ft 20,000 15,000 Sq. Do you currently own/operate any other franchises? Y / N If yes, please indicate franchise name(s), location(s) and type of business(es) How will you finance this franchise investment? Please indicate proposed management structure and names of individuals responsible for the development and finance of an Incredible Pizza Company Franchise: All information contained herein is confidential and is strictly for the purpose of facilitating the IPFG franchise application process. All applicants will receive consideration without regard race, color, religion, sex or national origin. The submission of this application does not obligate either the applicant or IPFG in any manner, nor does it imply that there is any legal or commercial relationship between either party. IPFG reserves the sole right approve or disapprove the Application for any reason it may determine, and in the event that IPFG disapproves the Application, it shall have no liability the undersigned. It is merely a preliminary procedure. Acknowledgment is made that the information supplied by me is true and correct. I hereby authorize Incredible Pizza Franchise Group, LLC. obtain any information about my credit hisry or other information that it deems appropriate evaluate my suitability as a potential Incredible Pizza Company Franchisee. Signature Date The application must be completed in its entirety with the following attached for franchise consideration: a) Resume(s) which details background, work experience and other pertinent affiliations for the above mentioned individual(s). Return Application and required attachments : Incredible Pizza Franchise Group, LLC 2772 South Campbell Ave Springfield, MO Phone Ext. 14 Fax franchiseinfo@incrediblepizza.com IPFG Franchise Application Page 4of 6 APRIL 2009
5 Corporate Name: Address: City State Zip CORPORATE, PARTNERSHIP, LP, LLP OR LLC FINANCIAL STATEMENT If you will be purchasing an Incredible Pizza Company franchise as an individual, please complete the financial information requested below. If you will be purchasing an Incredible Pizza Company franchise as part of a Limited Partnership (LP or LLP), Limited Liability Company (LLC), Subchapter S Corporation (S Corp) or Corporation (C Corp), please provide the most recent balance sheet and income statement for your organization. In some instances both personal and corporate financial statements are required. All Franchise Agreements must be signed individually and corporately. PERSONAL FINANCIAL STATEMENT (A separate financial statement can be attached in place of this statement) ASSETS LIABILITIES AND NET WORTH Cash on Hand and in Banks (Schedule 1) $ Notes Payable Banks-Unsecured (Schedule 1) $ US Government Securities (Schedule 2) $ Notes Payable Banks-Secured (Schedule 1) $ Trade Accounts and Loans Receivable (Schedule 3) $ Notes, Loans and Advances Payable Relatives $ Non-Trade Accounts and Loans Receivable Notes, Loans and Advances Payable Others $ (Schedule 3) $ Notes Receivable-Secured (Schedule 3) $ Contract Accounts Unpaid $ Notes Receivable-Unsecured (Schedule 3) $ Interest and Rents Payable $ Life Insurance, Cash Surrender (Schedule 4) $ Loans Against Life Insurance (Schedule 4) $ Scks and Bonds-Marketable and Accounts Payable $ Non-Marketable (Schedule 5) $ Real Estate (Schedule 6) $ Taxes and Assessments Payable (Schedule 6) $ Aumobiles-Market -Registered in Mortgages Payable on Real Estate (Schedule 6) $ Own Name Number of Vehicles $ Other Assets, Property or Investments (Itemize) $ Brokers Margin Accounts (Schedule 5) $ $ Liens on Real Estate (Schedule 6) $ $ Federal and State Taxes on Current Income $ $ Other Indebtedness (Itemize) $ $ Total Liabilities $ $ Net Worth $ Total Assets $ Total Liabilities and Net Worth $ ANNUAL SOURCE OF INCOME CONTINGENT LIABILITIES Salary and/or Fees $ Guaranr Obligations $ Bonus and Commissions $ Legal Claims $ Dividends and Interest $ Endorser or Co-Maker Obligations $ Real Estate Income $ Leases or Contracts $ Business, Profession or Royalty Income $ Liens or Special Debt $ Other Income (Itemize) $ Provision for Federal or Other Taxes $ $ Other Liabilities (Alimony, Child Support, Maintenance, etc.) (Itemize) $ Total $ Total $ IPFG Franchise Application Page 5of 6 APRIL 2009
6 Schedule 1 Banking Relations Name and Location of Bank Cash Balance Outstanding Loans, Guarantees Maturity of Loan Description of Security Schedule 2 Government Securities Description of Security Market Face Maturity Date Income Received Last Year Are Securities Pledged? Schedule 3 Accounts, Loans and Notes Receivable - Secured and Unsecured Name of Debr Maturity Date Face Monthly Installment Payments Balance Due Description of Security Schedule 4 Life Insurance Insurance Company Beneficiary and Relationship Type of Policy Face Amount Present Cash Surrender Amount of Policy Loan Annual Premium Is Policy Assigned? Schedule 5 Scks and Bonds Name of Sck/Bond Number of Shares/Bonds Face of Bonds Cost Market Income Received Last Year Are Shares/ Bonds Pledged? Schedule 6 Real Estate Address Title in Whose Name(s) Cost Market Balance on Mortgage Date of Maturity Installment Amount Use an additional Information Sheet if you need more space. IPFG Franchise Application Page 6of 6 APRIL 2009
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