Wara Sushi Franchise Application Form

STRICTLY CONFIDENTIAL

This document is not a contract and does not obligate either party in anyway in proceeding to purchasing a Wara Sushi Franchise.

You are required to complete this Application Form so that Wara Sushi can evaluate your interest and suitability for a Wara Sushi franchise. It is imperative that all information is true, accurate, and not in any way misleading. The information provided is to be held in strict confidence.

Review all the information in this document closely.
Every section must be completed, and each page is to be initialed.
All persons who will have an interest in the Franchise must complete a separate form.
If more details are required, please attach additional documentation.

APPLYING FOR

Primary Applicant Name*

First NameLast Name

State or Territory of Interest*

Location*

CBD (Capital City)Metro (Other Suburb)SuburbanRegional

Name of shopping centre or suburb of Franchise being applied for (if known)

Where did you find out about this opportunity?*

Are you open to relocating if an opportunity arises elsewhere?*

YESNO

Name*

First NameLast Name

Preferred Name*

Mobile Phone Number*

Please enter a valid phone number.

Home Phone Number

Please enter a valid phone number.

Email Address*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Marital Status*

Partner's Name

Number of Dependents

Please list their ages

Please select*

Australian CitizenPermanent ResidentStudentOther (Specify Below)

Are you permitted to work in Australia?*

YesNo

If not an Australian Citizen, please provide a copy of your Visa

Date Of Birth*

Are you a trustee of a trust*

YesNo

If yes, please provide a copy of the Trust Deed:

Name of Trust

Name of Trustee

Type of Trust

Discretionary TrustUnit Trust

If a Discretionary Trust, list the beneficiarie

If a Unit Trust, list each unit holder and their share or entitlement

EMPLOYMENT HISTORY

Current Employment

Company*

Date of Employment*

Date

Position*

Reason for Leaving*

Previous Employment

Company*

Date of Employment*

Date

Position*

Reason for Leaving*

Previous Employment

Company

Date of Employment

Date

Position

Reason for Leaving

Please provide an up-to-date resume

BUSINESS OWNERSHIP EXPERIENCE (if applicable)

Have you previously applied for a Franchise in any other industry, that has been approved or otherwise?*

YesNo

Have you previously owned a business?*

YesNo

Trading Name

Nature of Business

Years of trade

Is the business still operating?

YesNo

Business Number

ACNABN

Are you or your spouse/ partner involved in an other investment or business, whether financial or operating, that may or may not conflict with Wara Sushi?*

YesNo

If yes, please attach evidence and all information pertaining to your involvement including name and type of business, your position and investment level:

File Upload

HEALTH

Do you have any medical or psychological conditions that could affect your ability to run this business?*

YesNo

If yes, Please provide details:

If required, are you prepared to provide a medical certificate?*

YesNo

File Upload

LEGAL INFORMATION

Do you have any criminal convictions or impending prosecutions(s)?*

YesNo

If yes, Please provide details:

If required, are you prepared to provide a police certificate?*

YesNo

File Upload

(A Police Certificate provides details of any criminal history)

FINANCIAL INFORMATION

Please include household income.

**Note you will be required to show proof of your income and expenses.

How are you funding this opportunity? (Monthly Breakdown)*

	Monthly Income
Total Salary/Income
Bonuses/Comissions
Share Dividends
Real Estate Income
Other Business Income
Other Income
Other

(Monthly Breakdown)*

	Monthly Expenses
Mortgage Payments
Investment Loan Payments
Personal Loan Payments
Car Loan(s)
Credit Card Repayments
Utilities
General Living Expenses
Other Expenses

Total Income*

Total Expenses*

Net Position (Income-Expenses)*

	Assets
Cash and other Liquid Assets
Residential property market value
Investment Property 1 market value
Investment Property 2 market value
Investment / Shares
Motor Vehicle
Other Assets

	Liabilities
Mortgage Loan
Investment Loan(s)
Personal Loan(s)
Overdraft
Credit Card Limits
Utilities
Other Creditors

Total Assets*

Total Liabilities*

Net Worth (Assets - Liabilities)*

How will your franchise be funded?*

	Amount
Cash
Loan
Other

Funding Total*

Real Estate Schedule

	Residential Property	Investment Property 1	Investment Property 2
Property Address
Date Acquired
Purchase Price
Current Market Value
Original Loan Balance
Monthly Payments
Anticipated Loan Term Left

CREDIT HISTORY

Have you personally ever been bankrupt (whether discharged, pending, or current), the subject of a creditors petition, or had legal action (including being referred to a debt collection agency) commenced against you?*

YesNo