Thank you for your interest in Pestmaster Franchise opportunities. The completion and submission of this form places no continuing obligation on either Pestmaster, or the applicant. It will provide confidential information we need to determine if you are qualified to start the process of becoming a Pestmaster Franchise. This application form is not intended as an offer to sell, or the solicitation of an offer to buy a franchise. We offer franchises solely by means of our Franchise Disclosure Document (FDD). Certain states and foreign countries have laws governing the offer and sale of franchises. If you are a resident of one of these states or foreign countries, we will not offer you a franchise unless and until we have complied with all applicable legal requirements in your jurisdiction. Please attach additional pages as necessary. False or misleading statements on this form are grounds for terminating the application process and/or grounds for terminating your franchise, should you be granted one. This is not an employment contract or franchise agreement.

Please fill out all fields below:

Personal Data (for all persons involved in ownership of business)

First Name *

Middle Initial

Last Name

Are you a US Citizen?

If No, are you eligible to own a business in the US?

Street Address *

City

State/Province/Region

Suite, Bldg, Apt #

Postal/Zip Code

How long at current address?

If less than one year please list previous past 3 years:

Primary Phone / Cell # *

Primary Contact Email

If married: Spouses Name

How much net annual income would you like to make from this franchise?

Business and Employment History

Applicants current employment status:

Current Position Held:

How Long?

Past Jobs (please list all in past 10 years)

Previous Employment

From:

To:

Employer:

Position:

Salary:

What type of management experience do you have?

Spouses current employment status:

Position Held:

How Long?

Present Employer

Title

Job Responsibility

Have you ever owned a franchise or your own business?

If yes, what type of business?

Will this franchise be your sole source of income?

If no, please explain:

Have you ever failed in business, filed bankruptcy or compromised with creditors?

If yes, please give specifics:

Are you currently or have you ever been involved in any lawsuits?

If yes, please give specifics:

Have you ever been convicted of a crime?

If yes, please give specifics:

Education and Experience

Please indicate each level your complete and if you graduated:

High School:

Graduated:

College:

Graduated:

Major:

Please attach resume, if available

Financial Information

Will you require financing from a third party?

Do you plan to apply for Pestmaster in-house financing (up to 50% of franchise fee)?

Assets

List and describe all current assets.

	Amount ($)
Cash (all Financial Institutions)
Life Insurance CSV
Retirement Accounts
Real Estate Market Value (Primary home)
Other real estate owned
Other Assets

Annual Income
Primary Applicants Gross Income (salaries & wages)
Commissions and Bonuses
Dividends & Interest
Rental Income
Other Income (itemize each below)


Spouse's Gross Income
Other Income (itemize each below)

TOTAL INCOME

Annual Expenditures
(Estimated) Mortgage/Rental Payments
(Estimated) Insurance Premiums
(Estimated) Credit Cards
(Estimated) Consumer Loan Payments
(Estimated) Alimony, Child Support & Maintenance
(Estimated) Home Utilities
Other Expenses
TOTAL EXPENDITURES

Please list your preferences for locations if granted a Pestmaster Franchise:

Location 1:

Location 2:

Location 3:

If that area is not available, are there other areas of interest? Please list:

Location 1:

Location 2:

Location 3:

If granted a Pestmaster Franchise, when will you be available to open a location?

If granted a Pestmaster Franchise, when will you be available for training?

Do you intend to work full or part time? (Semi Absentee )

If part-time do you agree to hire a full-time licensed manager?

What is your business objective? (Why do you want to become a Pestmaster Franchisee?

How did you become interested in a Pestmaster Franchise ?

Please explain your understanding of franchising:

Comments: Please tell us anything else you think is relevant, such as family business history, your personal business objectives, and what your most significant contribution would be to this business:

I am submitting this franchise information to obtain further information about the Pestmaster Franchise System. I understand that neither Pestmaster nor I are under any obligation whatsoever. Should I proceed with my investigation of the Pestmaster Franchise opportunity, my signature constitutes my approval for you to make a routine check and conduct such other searches, to include a credit and background check, as you may consider appropriate. The undersigned warrants that this information is true and correct and that Pestmaster may consider this statement as true and correct until a written notice of change is given to Pestmaster by the undersigned.

Signature

By typing your name here, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.

Date

***This form is not to be construed as an offer of a franchise, a commitment or binding agreement on either party.

All information provided will be kept strictly confidential. Pestmaster insists that all information provided you be kept confidential.