Franchise Application - Grain and Berry · Franchise Application Instructions Thank you for your interest in the Grain & Berry Cafe LLC franchise system. The following will outline

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Grain & Berry Cafe LLC. 33840 US Hwy 19 N

Palm Harbor, FL 34684 [email protected]

Franchise Application(An individual application must be completed by Applicant and each partner)

Grain & Berry Cafe, LLC 33840 US Hwy 19 N, Palm Harbor, FL 34684

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Franchise Application InstructionsThank you for your interest in the Grain & Berry Cafe LLC franchise system. The following will outline the process and steps that are required to be considered for a franchise:

1. Complete this Franchise Application and return to us by mail – Grain & Berry Cafe, LLC,33840 US Hwy 19 N, Palm Harbor, FL 34684, Attn: Franchise Review. A duplicate copy canbe scanned and emailed to [email protected] to expedite the process, but theoriginal copy with original signatures, must also be received.2. A separate Franchise Application should be completed by each applicant.3. Upon receipt, we will review and evaluate your application and, if approved, provide you aFranchise Disclosure Document (FDD).4. We may provide you with a FDD in hard copy or electronic format. If the FDD is furnishedelectronically, it will be provided in a Portable Document Format (PDF) file. You must use theAdobe Acrobat program in order to open and view this type of electronic file.5. Upon receipt of the FDD, please complete and sign the final two pages of thedocument entitled “Receipt”. Once completed and signed, return the Receipt entitled “OurCopy” to the address indicated above.6. It is recommended that you review our FDD with your attorney and business advisors.

Under no circumstances does the submittal of your application to us or its subsequent review and processing imply, in any manner, our intention to offer you a Franchise. You are not accepted as a Franchisee unless and until you and Grain & Berry Cafe LLC execute a Franchise Agreement.

We do not guarantee the financial performance of any Franchisee or business. The decision to become a Franchisee and to open a restaurant within our system must be based upon your independent research and analysis.

Confidential Franchise Application Initials:

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Application FormThe information you provide will be held in the strictest confidence and completion of this form in no way constitutes a commitment to Grain & Berry Cafe LLC or that a franchisee applicant will be automatically awarded. We encourage you to share any relevant information and include anything that you find will make your candidacy stand out as a potential franchisee. Thank you again for your interest in a Grain & Berry franchise.

About YourselfFull Name:

Home Address:

City State or Country: Postal Code:

How long at this address:

Home Phone: May we contact you here? Yes __ No __

Work Phone: May we contact you here? Yes __ No __

Cell Phone: May we contact you here? Yes __ No __

Are you a citizen of the United States:

Other InformationDescribe your current business activities ( A separate resume is acceptable):

Current occupations of your proposed Operations Team:

Have you ever been convicted of a felony?

Have you or anyone on your ownership team ever filed for bankruptcy? Date Filed: Date Discharged:

Describe any lawsuits that you have been involved in and the nature of the lawsuits.


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Do you have any restaurant industry experience? ____Yes _____No If yes, please advise with what company, position and number of years with the company.

Do you or any persons related to you have any connection with any other restaurant business? If yes, provide relationship, name and nature of business below. ____Yes _____No

Do you or any other persons (whether related to you or not) associated with you have any connection with any other restaurant business? If yes, explain below.: ____Yes _____No

Are you involved, or have you been involved in a business that may restrict you from franchising with Grain & Berry? ____ Yes ____ No

Financials(All information provided is strictly confidential and will be treated as such)

Assets Liabilities

Cash on Hand and in Banks $ Mortgages $

Marketable Securities $ Accounts Payable $

Retirement Plan $ Notes Payable $

Accounts and Notes Receiv-ables

$ Loans on Life Insurance $

Real Estate $ Credit Cards (Total Balance) $

Personal Property $ Unpaid Taxes $

Business Holdings $ Other Liabilities $

Total Assets $ Total Liabilities $

Minus Total Liabilities $

Net Worth $


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Real Estate Owned

Address 1:

Do you or any Date Purchased:

Original Cost: $

Present Value: $

Mortgage Balance: $

Address 2:


Original Cost: $

Present Value: $

Mortgage Balance: $

Address 3:


Original Cost: $

Present Value: $

Mortgage Balance: $

Income/Expenditures

Salary $ Loan Co-Signature $

Retirement Plan $ Legal Judgment $

Investment/Interest Income $ Loans on Life Insurance $

Real Estate Income $ Income Taxes $

Other $ Other Special Debt $

Total $ Total $


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Specific Data

Assuming your review of Grain & Berry is positive, what is your desired time frame to open a franchise?

Describe any training/experience in sales, marketing, management or retailing:

Why do you think a Grain & Berry franchise will enable you to reach your personal goals?

Area/Location Preference 1. 2. 3.

Who will be responsible for daily operations?

Amount of cash available for investment: $

Source of cash for investment:

Do you have access to financing? Yes __ No __ If yes, explain below.

Have you been approved for business financing? If so, what amount have you been approved for?

Would this business be your sole source of income?

What questions do you have about this opportunity?


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Authorization for InvestigationI/We represent and warrant that all of the statements made by me/us in the above application are true and correct. I/We understand that if I/we make a false statement, such action will terminate my/our application for consideration. I/we understand that by signing this application, I/we authorized Grain & Berry Cafe LLC to check my/our credit with a credit bureau, conduct a background and criminal investigation and conduct whatever investigation as permitted under the Fair Credit Reporting Act (FRCA). I/We agree that this application shall be and remain the property of Grain & Berry Cafe LLC whether or not this application is approved. By my signature below, I hereby authorize all corporations, former employers, credit agencies, educational institutions, law enforcement agencies, city, state, county and federal courts and agencies, military services and persons to release all information they may have about me including criminal and driving history. This authorization shall be valid in original or copy form.

The undersigned agrees to sign a personal guarantee for his/her Grain & Berry Franchise. (Please Check Box)

I/We understand that this application does not obligate either party to engage in a business transaction in any manner.

Applicants Signature: Date:

Partner of Spouse’s Signature: Date:

Applicant’s Partner or Spouse’sDate of Birth:

Social Security No:

Drivers License No.:

Current Address


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Please use this area if additional space is needed to answer any questions on the previous pages.


Documents

Franchise Application - Grain and Berry · Franchise Application Instructions Thank you for your interest in the Grain & Berry Cafe LLC franchise system. The following will outline