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goddard school application
  FRANCHISE GODDARDYSTEMS,NG, 1016WestNinthAvenueKingofPrussia, A 19406610-265-85108OO-272-49O1Fax:610-265-6931Membelnternationalranchise ssociation  FRANCHISE PPLICATION A complete investigalive backgroundreport may b€procuredin connectionwithyourapplication.In the€vent such aninvestigative consumer reportisprocurcd,uponyourwrittenrequestofthis companyr reoeived within ar€asonableperiodof time trom the date ofthisapplication,youwill beprovideda completeand accurate disclosure of thenatuneand scope ofthe investigation requested, Appliqant:Spouse: (SocialSecurityNumber)Namen Full:(First) (trliddle) (Last)(Socialecudtyumber)Hom€Addr€ss;Street)(C'ly)(State)(County)(zipCode)Home elephoneumber PERSONAL ATAApplicanq DaleofBidh: EmailAddressMadtalSlatusNo.ofDependerdsAr€youa U,S,Citizen?DYestrNolf not a U.S.Ciiizen, oyouhavepermanentesident/greenad status? trYestrNo(Pfeasee advisednatwe may equestoseeWurgrcencad oratherdocum$tationalidencingWWmmigrationtatus.)Haveouever ived utside f heUniled tatesevenfyouareaU.S.Cilizen)? trYes trNolfyes,addr$sesand corr€spondingates:DatesStreetAddressCitvCountrYl.lame ndAddress t Employer:PositionDesc.iption:Annuaincome:Frombusiness onnection rpracticeFrom onds ndsbcksFrom ealesl,ateBus. elephoneumber: BUSINESSXPERIENCELastwopositionspriorto above) Fom ToFirm Nameand AddressPositionAnnualncomo DetailedDescriptionfBusiness xperience:RECORDOFEDUCATPNTypeSchool CouragofSludyYeersAilendedDkl YouGiaduate? De$€eRecei!,€d HighSchool NameFromCily & Stat6To College NarneFromCily& Staie Other NameFromCily & StateTo MILITARYERVICE ECORD Didyouserve n he U.S. umedForces?Dates fSeMce; trYestrNoto f Yes,WhatBranch?TypeofDischargo:  FINANCIALACKGRoUNDApplicant&spouse) PersonalBankAccountsBugine6sBank AccountsName lBankNameof BankAddressName l BankAddlessNamef BankAddress Financial Statement RealEstaleHoldingslncludingHomelItescriotion f ProDertvnd morovementsTitle n 'lameOf DateAcqui|€dMarketCostValueCurEntMortgageBalance MISCELLANEOUS Are hereany unsatistiedudgmentsrlegalactionspendingagainstyou?Haveyoupledged,assigned, ypothecatedr transferreditle o any oltheassetsisted in thepersonalstatement?Haveyoueverbeen convictedof a telony or misdemeanorotherthan minor traffic violations?Ar€ anyelonyor misdem€anorhargespendingagainstou?Haveyoueverbeen bonded?It bonded,whichobs Haveoueveronehroughankruptcy,rmadegeneralssignment?Doyouhave nycontingentiabilitiessco-maker,uarantor,esse6, ortgagee, on contraclsoror tax claims? Applicani trYes trNonYestrNotrYestrNotrYes trNotrYes tr No Spousetl Yes trNotrYes trNotrYe9 trNotrYes n NotrYes trNoEYes trNotrYestrNo trYestrYes trNotrNoASSETSLIABIL]TIES CashCheckingccounts) NotesPayableo BanksUnsecured Cash(SavingsAccounts)NotesPayableo BanksSecuredRealEstateRssidenceCun€ntValue)AccountsPayableReal Estate-Investm€nt(Cunent Value)RealEstateMortgagesPayableResidenceStocks, Bonds& SecuritiesGxdudins01K& FA)RealEstateMortgagesPayablelnvestment 401KBrokersarginccounts IRAOtherLiabilitiesltemize) TotalAssets Total LiabilifesTotal Assets(Less)TotalLiabilities =Net Worthlfyouhaveanswered (es to anyof theseabovequestions,pleaseexplain:  PERSONALATASpouse) Date f Birth:Areoua U.S.Cilizen? trYestrNolf nola U.S.Cilizen,oyouhayeermanentesidenvgreenard tatus? nYestrNo(Pleasee advised hatwa may cquesto$eeWurgreenardor otherdocumentaton videncingouimmigration tatus.)Haveyouever ivedoutside f th€ UnitedStatesevenfyouareaU.S.Citizen)?trYestrNolfyes,addresse$ndcorrespondingates:DatesStre€lAddresgCitvCourirvNamsndAddressf Employer;Positionescription;Annualncome:Bus. €l€phoneumber:From usinessonneclionrpractice...........,..,$Fromondsnd tocka . . . . . . ......,...$Fromealesbte..... ..... ... $Other ncome Pleasetate sourca . ..., , . . . . , . . . . . .$ Detailedescriptionf BusinessExperience:BUSINESS XPERIENCELastwopositionspriorto above) From To Fi]m Namo and Address PositionAnnualncome RECORDOFEDUCATIONTypeSchool Cou,se ofStudyYe€laAltendedDid YouGraduate?D€grreRecehred HighSchool Name From Cily & SlateTo College NameFromCity & Shte to Other NameFrcmOty & State TO MILITARYERVICEECORD Didyouserve n theU.S.ArmddForces?tryestr NoDatesf Serv{c€:toTypeof Discharge: I understandhat hisapplications nota contractnddoesnotcreateanyobligationsn thepartofGoddardystems,nc.or mysell.Employersamedby men thisapplication ill notbe contactedy GoddardSystems,nc. untilsuch imeas acontracts executedetweenGoddardystems,nc.andme. Applicant'sSignatureSpouse'sSr?nature THISAPPLICATIONOESNOTOBLIGATE ITHERPARTYN ANYMANNER, It Yes,WhatBlanch? Date
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