Franchise Opportunities:
 
Franchise Opportunities
Qualification Sheet                            * - Required Information
Personal Information
Name:*
Age:*
Home Address:*
Years There?
City*
State*
Zip Code:*
Social Security #:*
Date of Birth:
If married, spouse's first name:
# of Dependants:
Home Phone:*
Business Phone:
Email Address:*
Work History & Experience - (Last 5 Years Including Present Job)
Company #1 Name and Address:*
Position:*
Ave. Annual Income:*
Company #2 Name and Address:*
Position*
Avg. Annual Income*
Company #3 Name and Address*
Position*
Ave. Annual Income*
Education - (Last Year Completed)
High School*
College*
Graduate*
Your Assets
Checking Account*
Savings Account*
Other Accounts*
Home (Fair Market Value)*
Stocks and Bonds*
401K / IRA*
Autos*
Other Real Estate (Fair Market Value)*
Other Assets*
Total Assets*
Are your assets in a Trust?
Additional Sources of Income (please specify)
Your Liabilities
Personal Loans*
Business Loans*
Home Mortgage*
Other Mortgages*
Other Obligations*
Total Liabilities*
Total Assets minus Total Liabilities*
General Information
What Geographic Market are you interested in?*
First Choice*
Second Choice
Third Choice
Will you be willing to relocate or accept another location?
If Yes, Where?
What prompted you to Contact Car-X?*
Do you have a friend or relative that is presently affiliated with Car-X?
If Yes, describe the relationship:*
Have you ever owned your own business?*
If Yes, please Explain:
Do you have a financial interest in other businesses?*
If Yes, please explain:
Are you a defendant in any legal suits or legal actions?*
Have you been convicted of any crime other than a minor traffic offense?*
If Yes, please explain:
Have you ever taken bankrupcy within the past 7 years?*
Is your financial position adequate to presently make the initial investment?

I hereby authorize Car-X Associates Corp. to check my credit and employment history and recieve answers to the questions asked regarding credit experience with the references listed.
References
Business:
Individual #1
Title
Company
City
State
Phone*
Individual #2
Title
Company
City
State
Phone*
Character:
Individual #3
Title
Company
City
State
Phone*
Individual #4
Title
Company
City
State
Phone*
Agreement
I would like to be considered as a possible Car-X Auto Service Franchisee. I understand that the agreement of this application does not commit me or Car-X Associates Corp. in any way and that all information provided will be held in the strictest confidence. Any material misrepresentation of my financial position provided in this qualification sheet shall be adequate ground for Car-X Associates Corp. to rescind any agreements entered into with me in reliance upon such data. I hereby authorize Car-X Associates Corp. to verify through usual and customary commercial channels the information provided by me. I understand that I may request a copy of any report obtained by Car-X Associates Corp. in verifying my financial position. In the event of a meterial change in the data contained herein, I will promptly advise Car-X Associates Corp. of same. If I am accepted as a Car-X Associates Corp. Franchisee, I authorize Car-X Associates Corp. to disclose this and any credit information which may be obtained by Car-X Associates Corp.. Upon approval for franchise interview, Car-X Associates Corp. will require that all applicants file a detailed financial statement.
*Required
Complete
Auto
service		  
UNDERCAR: ABS Repair | Axle Repair | Brake Repair & Service | Car Tires | Catalytic Converters
CV Joints & Shafts | Drive Line Repair | Exhaust & Muffler Repair | Four Wheel Drive Repair | Rack & Pinion
Shock Absorbers & Struts | Springs | Steering & Chassis | SUV & Truck Tires | Tire Repair | Universal Joint
Wheel Alignment | Wheel Balancing | Wheel Bearings
 
UNDERHOOD: Air Conditioning Systems | Alternators & Starters | Belts & Hoses | Car Batteries
Complete Engine Repair | Computerized Engine Diagnostics | Cooling System Repair & Service
Electrical Systems | Emission Repair | Factory Scheduled Maintenance | Fuel System Injector Cleaning
Fuel Pumps & Lines | Oil change, Filters & Lube | Radiator Repair & Service | Timing Belts & Chains
Towing Service | Transmission Service & Repair | Tune Ups | Water Pumps
 
EXTERIOR/ACCESSORIES: Headlights | Electrical Accessories | Power Window Repair | Trailer Hitches
Windshield Wipers
   
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