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Franchising Opportunities

Payroll Matters® Franchising Opportunities

Part One: Personal Information
First Name
Last Name
Age
Spouse Name
Age
Home Phone
Business Phone
Mobile Phone
Email Address
Number of Dependents
Age(s) of Dependent(s)
Current Address
City
State
Zip
Years at Current Address
Do You Own Your Home?
Previous Address
City
State
Zip
Years at Previous Address
Part Two: Financial Information  
Assets    
Cash  
Accounts & Loans Receivable  
Life Insurance Cash Surrender Value (Do not deduct loans)
Stocks & Bonds  
Real Estate  
Automobiles  
Other Assets (Please Itemize)
Total Assets  
Liabilities    
Notes Payable to Banks  
Notes Payable to Others  
Loans Against Life Insurance  
Accounts Payable  
Mortages Payable on Real Estate  
Other Liabilities (Including Credit Cards)
Total Liabilities  
Net Worth    
Net Worth (Assets - Liabilities)  
Part Three: Banking/Income  
Banking Relations    
Name of Bank  
Location  
Cash  
Outstanding Loan Amount  
Source of Income (Annual)    
Salary  
Bonus and Commissions  
Dividends  
Real Estate Income  
Other Income (Please Itemize)
Total Annual Income  
Part Four: Real Estate, Investments, and Insurance  
Schedule of Real Estate Owned    
Description of Property & Improvements  
Date Acquired  
Title in Name of  
Market Value  
Mortage Amount  
Mortgage Maturity  
Stocks and Bonds    
Face Value Bonds/No. of Shares (Please itemize)
Description of Security(ies) (Please itemize)
Registered in the Name of  
Cost  
Current Market Value  
Income Received Last Year  
Insurance    
Name of Insured  
Name of Beneficiary  
Name of Insurance Company  
Type of Policy  
Face Value of Policy  
Total Cash Surrender Value  
Total Loans Against Policy  
Amount of Annual Premium  
Part Five: Education and References  
Education beyond high school    
Institution 1  
Years  
Certificate/Degree  
Institution 2  
Years  
Certificate/Degree  
References    
Reference 1 Name  
Address  
Phone  
Occupation  
Reference 2 Name  
Address  
Phone  
Occupation  
Reference 3 Name  
Address  
Phone  
Occupation  
Part Six: Work Experience  
Empoloyment Inoformation    
Employer ("Self" is acceptable)
Years  
Address  
Phone  
Salary  
Position  
Responsibilites  
Previous Employer ("Self" is acceptable)
Years  
Address  
Phone  
Salary  
Position  
Responsibilities  
Part Seven: Brief Questionnaire  
How did you become interested
in our franchise?		  
What is your geographic preference?  
What is your time frame to begin?  
How much capital can you invest?  
Do you currently have a source
for financing? 		(Please explain)
Have you or your spouse ever owned,
operated, or managed a retail location?		 (Please explain)

To what extent will you be actively
involved in the day-to-day operations
of your location?

  
Why do you feel you would make a
good Payroll Matters® franchisee?		  
Have You Ever:    
Been party to a lawsuit?  
Filed Bankruptcy?  
Had a Real Estate loan foreclosed?  
Been convicted of a felony?  
If your net worth is less than $100,000,
how will you finance your franchise?		  
What else would you like us to know
about you?		  
Part Eight: Submit Form
By clicking "Submit," I certify that the information that I have provided on this application is complete and correct. It is understood and agreed that any misrepresentation by me on this application will be sufficient cause for cancellation of this application and other legal remedies. I hereby authorize Payroll Matters® or its authorized agent and third parties to provide or obtain any information referenced above. I authorize the release of such information to Payroll Matters® or its authorized agent by such third parties.
Full Name: Date:


Services for Franchisees
Initial Investment Estimates
Commonly Asked Questions
The Bottom Line
Outside Payroll Service Benefits
Checks and Balances
From the Beginning
Division of Labor
Why Should I Buy a Franchise?
Franchise Application