Online Qualification Form

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Confidential Qualification Sheet.


Personal


WORK HISTORY AND EXPERIENCE

Last 5 Years Work History (including present job).


Company Name and Address
Position
Avg. Annual Income

1


2


3


EDUCATION:

Select last year completed


YOUR ASSETS:


YOUR LIABILITIES:


GENERAL INFORMATION

What geographic market(s) are you interested in?


REFERENCES

BUSINESS


Individual
Title
Company
City
State
Phone

1


2


CHARACTER


Individual
Title
Company
City
State
Phone

1


2



I would like to be considered as a possible Tuffy® Tire & Auto Service Center Franchisee. I understand that the signing of this application does not commit me or T.A.C. 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 T.A.C. to rescind any agreements entered into with me in reliance upon such data. I hereby authorize T.A.C. 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 T.A.C. in verifying my financial position. In the event of a material change in the data contained herein, I will promptly advise T.A.C. of same. If I am accepted as a T.A.C. Franchisee, I authorize T.A.C. to disclose this and any credit information which may be obtained by T.A.C. Upon approval for franchise interview, T.A.C. will require that all applicants file a detailed financial statement.