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 Tuffy Corporate 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 Tuffy Corporate to rescind any agreements entered into with me in reliance upon such data. I hereby authorize Tuffy Corporate 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 Tuffy Corporate in verifying my financial position. In the event of a material change in the data contained herein, I will promptly advise Tuffy Corporate of same. If I am accepted as a Tuffy Corporate Franchisee, I authorize Tuffy Corporate to disclose this and any credit information which may be obtained by Tuffy Corporate Upon approval for franchise interview, Tuffy Corporate will require that all applicants file a detailed financial statement.