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Are there any suits, judgements, tax deficiencies, or other claims pending or in prospect against you? Yes No
If yes, please state the details: ____________________________________________________________
____________________________________________________________
__________________________________________
I furnish the foregoing statement and information for the purpose of
obtaining approval as a Franchisee and for securing credit and other
considerations. I acknowledge that Princeton Information Technology
Center is relying on the information provided in this application, in
addition to other information, in making its decision whether to grant
a franchise to me. I represent that the information contained in this
application is true and correct. I further represent that the information
contained in this application is complete and not misleading due to an
omission of any material information. I agree to advise Princeton
Information Technology Center immediately of any material changes
in any of the information contained in this application. I agree to supply
such additional information, statements or data as Princeton Information Technology Center may request. I understand and acknowledge that
Princeton Information Technology Center, in its sole discretion, may or
may not approve the application. I authorize the procurement of an
investigative consumer report and/or credit check and understand that
it may contain information about my background, character, general
reputation, mode of living, credit worthiness and job performance. I
hereby authorize my banks, finance company, and/or other financial
institution to release to Princeton Information Technology Center to
make all inquiries deemed necessary to verify the accuracy of the
statements made herein, and to determine my credit worthiness. Princeton Information Technology Center is authorized to release financial and
other information concerning me as may be requested by prospective
financing sources.
Signature: ______________________________________________
Name: __________________________________________
Date signed: __________________________
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