Please Type Name To Accept Disclaimer
In submitting the foregoing information, the undersigned guarantees information as complete and true personal and financial condition as ofthe date shown. The undersigned understand that Surveillance Secure Franchise LLC. is relying upon all the above information as materialfactor in considering application for a franchise agreement. This is not a contract; supplying or completing this form incurs no obligation oneither party.The undersigned understands that prior to awarding a franchise agreement, Surveillance Secure Franchise, LLC., will conduct a credit andcriminal background check. At the appropriate time prior to awarding a franchise agreement, the undersigned, will be required to provide the necessary information and approval to conduct such investigations. Offering is made by prospectus only.