BIGGBY COFFEE Franchise Application

General Information

Full legal name (first, middle, last):*

First Middle Last

Other legal names (for example aliases, maiden name, other):

Phone number:*

Email address:*

Current Street Address:*

Street Address Address Line 2 City State ZIP Code

County*

How long have you lived at this address?

Years:*

Months:*

Social Security Number:*

Date of Birth*

Driver's License # or State ID #*

Driver's License State*

Are you legally authorized to work in the United States?*

Yes

Have you ever filed for bankruptcy?*

Yes

If so, when? What type? Please explain:*

Have you ever been refused a bond?*

Yes

If so, when? Please explain:*

Have you ever been the defendant in any criminal or civil legal proceeding?*

Yes

If so, when? Please explain:*

Have you ever had a judgement(s) in any criminal or civil proceeding against you?*

Yes

If so, when? Please explain:*

Have you ever been convicted of a felony?*

Yes

If so, when? Please explain:*

In what County and State would you like to locate your BIGGBY® COFFEE?

County:*

State*

What is your target date for opening?*

Financial Information

Assets (Numbers Only)

Cash – Checking:*

This is the total amount you have accessible to you in all checking accounts.

Cash – Savings:*

This is the total amount you have accessible to you in all savings accounts plus any cash on hand.

Investments:*

The total dollar amount of any type of stocks, bonds, or other business investments, not including IRA, Pension, or 401K type accounts.

Real Estate:*

The fair market value of any real estate holdings you have personal home, rental properties, land.

Autos:*

The fair market value of any vehicles you own, possibly check Kelly Blue Book for assistance.

IRA / Pension / 401k:*

The current combined value of these type of accounts, if applicable.

Personal Property:*

The fair market value of your personal belongings such as household goods, tools, boats, RVs, jewelry, collections, etc.

Other Assets:*

This is a catch all for anything else not included above.

Total Assets:*

Liabilities (Numbers Only)

Mortgage:*

The total dollar amount owed in relation to Real Estate Assets listed above.

Installment loan(s):*

The total dollar amount owed on any Autos, Personal Property, or Other Assets listed in Assets.

Credit Card(s):*

Total dollar amount owed on all credit cards.

Other Liabilities:*

Total dollar amount owed on any other debt such as student loans, medical bills, or personal loans.

Total Liabilities*

Net Worth*

Cash to Invest*

Current Credit Score*

Credit Score Source*

Please explain how you plan to finance this business venture:*

Sources of Income

Extra information for Assets/Liabilities

Annual Income (Numbers Only)

Primary Income:*

Your primary source of income.

Secondary:*

Income that comes from your spouse, a 2nd job, contract work, or any other type of consistent income.

Bonus/Commission:*

Any type of bonus that you have the potential to earn but is not guaranteed.

Dividends / Interest:*

Any income you receive from investments that is consistently paid out to you monthly, quarterly, or yearly.

Rent(s) / Royalty Revenue:*

Any rent you collect from any owned Real Estate, or royalty payments you receive.

Other Income:*

Any other type of consistent income not already covered.

Total Annual Income:*

Annual Expenses (Numbers Only)

Yearly Mortgage/Rent Payment:*

The total amount you pay for any real estate owned or rented. If your taxes and insurance are included in your mortgage payment, please use the full number.

Property Taxes:*

Your yearly property taxes if NOT included in your mortgage payment.

Insurance (Home/Auto):*

Your yearly insurance payments for your home and auto. If your homeowner’s insurance is included in your mortgage payment do NOT include it here, only list any other insurance payments.

Alimony / Child Support:*

Total paid each year.

Personal Expenses:*

Total amount it costs to run your household that are not already included such as food, gas, utility bills, etc.

Income Tax Due:*

Any debt owed for taxes that is not already taken out of your regular paycheck.

Other Expenses:*

Any other yearly expense not already covered, balloon payments due, etc.

Total Annual Expenses:*

Net Annual Income*

Partner Information

All partners must complete their individual Franchise Application.

Check below to add a partner

Add a partner

Partner's Name*

Partner's Email*

Partner's Phone*

What will be their role in the BIGGBY® COFFEE?*

Percentage of Ownership*

Who will run daily operations?*

Who will be the primary contact?*

Additional partners?

add another partner

Partner's Name*

Partner's Email*

Partner's Phone*

What will be their role in the BIGGBY® COFFEE?*

Percentage of Ownership*

Additional partner?

add another partner

Partner's Name*

Partner's Email*

Partner's Phone*

What will be their role in the BIGGBY® COFFEE?*

Percentage of Ownership*

Today's Date*

Signature*

If awarded a BIGGBY® COFFEE franchise, I promise to operate the franchise in full accordance with the Franchise Agreement I will sign. It is understood that this is not an offering for a franchise and the purpose of this Franchise Application is for general information and is in no way binding upon either the Company or me. It is, however, understood that all information I supplied is true and accurate to the best of my knowledge and ability and that the company will rely on this information to evaluate my qualifications. I hereby consent to a credit report and a background check to be obtained by the Company. I authorize you to make investigations of my credit, criminal record, character, and ability, and to contact anybody, whether or not listed above, including former employers, in order to obtain personal information about me. Further, I release all such persons from any liability or damages that may be incurred as a result of furnishing of such information. I also certify that all the information in this Franchise Application is true and complete.

We appreciate your interest in BIGGBY COFFEE franchise opportunity and invite you to look for an available territory near you. MI, OH, KY, IN, TN, IL, ID, WI, NJ, VA, NC, SC, GA, FL.

By pressing Submit, you're agreeing to receive information from BIGGBY COFFEE Franchise via email/call/text at the number you provided in your inquiry above. Data and message rates may apply.

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