FCC CONFIDENTIAL QUESTIONNAIRE

YOUR INFORMATION

Please take a few minutes to complete The FCC Confidential Questionnaire as thoroughly as possible. This information will greatly assist your consultant in identifying franchise opportunities that best match your requirements.
Name*

First NameLast Name
Age
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Phone Number*

Area CodePhone Number
Your E-mail*
Your Consultant's Name*

First NameLast Name
Your Consultant's Email (Please Verify Spelling)*
Name@TheFranchiseConsultingCompany.com

FAMILY INFO
Spouse's Name

First NameLast Name
Children?
What Ages?
Do you have Native American heritage? You may be eligible for special loans from the SBA.

YesNo

FINANCIAL STATEMENT - ASSETS

All franchises require financial information as part of the pre-qualification process. Based on your numerical answers, the form automatically calculates. Assets - Liabilities = Net Worth.
Cash (Checking & Savings)
Please enter numbers only - 5 / 500 / 5000 / 500000 / etc.
Stocks, Bonds, CDs
Home Market Value
401(k)
IRA
Roth IRA
Autos
Personal Property
Money Due You
Yearly Pensions
Other Assets
Total Assets

FINANCIAL STATEMENT - LIABILITIES

All franchises require financial information as part of the pre-qualification process. Based on your numerical answers, the form automatically calculates. Assets - Liabilities = Net Worth.
Credit Card Debt
Please enter numbers only - i.e. 50000 / 100000 / etc.
Auto Debt
Mortgage Outstanding
Line of Credit Outstanding Balance
Accounts Payable
Other Debts
Total Liabilities
Net Worth (Total Assets minus Total Liabilities)

FINAL THOUGHTS ON FINANCING
Capital Available for Investment?*
Please enter numbers only - i.e. 50000 / 100000 / etc.
Credit Score*
Do you plan to have a partner and/or investor?
Will partners / investors be active in the business?
Other thoughts?

CONSULTANT COMPENSATION
Typically consultants are compensated when you sign a franchise agreement and you have paid the franchise fee to the franchisor. With certain brands, the consultant is paid by the franchisor as a percentage of the franchise fee or by other compensation, such as a share of the profits. You will never be asked to pay a consultant directly.*

I Agree
Should be Empty:

YOUR INFORMATION