Request For Consideration

Step 1 of 3

Applicant's Full Name*
First Last
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of Birth*
MM slash DD slash YYYY
Primary Phone Number*
Current Marital Status*
Spouse's Name*
First Last
Spouse's Occupation*
Please Upload Your Resume*
Max. file size: 1 MB.

Financial Information
Assets
My current credit score is:*
Cash on Hand and in Bank*
Savings Funds/Certificates
Stocks, Bonds, and Securities
Retirement Plans, IRA's, 401(k)'s
Home Market Value
Other real estate (market value)
Autos (market value)
Money Due To You
Personal Property
Other Assets
Total Assets (please add up the fields above and put value here)
Liabilities
Notes Payable
Revolving A / C Balances
Charge Card Balances
Home Mortgage Balance
Other Real Estate Debt
Auto Loans
Other Liabilities
Total Liabilities (please add up all above fields and put value here)
Net Worth
Net Worth (Total Assets less Total Liabilities)
Cash Availability
Cash or liquid capital you have for this investment:*
Other Questions
Do you have a business partner?*
Do you plan to have investors?*
Have you or your spouse ever been involved in a personal or business bankruptcy?*
Have you or your spouse ever been convicted of a crime?*
Are you or your spouse currently under any type of criminal investigation?*
Have you ever had a DWI (DUI)?*
Are you or your spouse currently involved in any pending civil lawsuits?*
Disclaimer*
EVERYTHING THAT I HAVE STATED IN THIS APPLICATION IS TRUE AND ACCURATE, AND I UNDERSTAND THAT THE INFORMATION PROVIDED BY ME WILL BE RELIED UPON BY THE FRANCHISOR [REDEBINS USA].
EVERYTHING THAT I HAVE STATED IN THIS APPLICATION IS TRUE AND ACCURATE, AND I UNDERSTAND THAT THE INFORMATION PROVIDED BY ME WILL BE RELIED UPON BY THE FRANCHISOR [RED-E-BINS Franchising LLC]. The submission of this Application does not obligate either you or the franchisor in any manner nor does it imply that there is any legal or commercial relationship between either party. I understand that the granting of a RED-E-BINS franchise is at the sole discretion of the franchisor and that acceptance of this Application is not the grant of (or a promise to grant) a franchise. Franchises are granted only by the execution of a written franchise agreement by you and the franchisor.

I understand that any information I received from the franchisor or its affiliates or any of their employees, agents, or franchisees is highly confidential (“Confidential Information”), has been developed with a great deal of effort and expense to the franchisor and is being made available to me solely because of this Application. I agree that I will treat and maintain all Confidential Information as confidential, and I will not, at any time, without the express written consent of the franchisor, disclose, publish, or divulge any Confidential Information to any person, firm, corporation or entity, or use any Confidential Information, directly, for my own benefit or the benefit of any person, firm, corporation or other entity, other than for the benefit of the franchisor.

I authorize the release of any information deemed necessary by the franchisor to verify any and all of the information contained in this Application. This authorization for release of information includes but is not limited to matters of opinion relating to my background, mode of living, credit worthiness, character, ability, reputation, and past performance. I understand that I have a right upon written request to the franchisor to provide information regarding the nature and scope of such investigation. I authorize all persons, schools, companies, corporation, credit bureaus, and law enforcement agencies to release such information without restriction or qualification to investigatory parties selected by the franchisor, any of its officers, agents, employees and servants. I voluntarily waive all recourse and release them from liability for complying with this authorization. This authorization and release shall apply to this as well as any future information request. I authorize that a photocopy or facsimile of this authorization and release be considered as valid as the original.
Name*
First Last
Entering your name here constitutes a digital signature.
Today's Date*
MM slash DD slash YYYY

Request For Consideration

Step 1 of 3

Business Opportunity

Financial Information

Assets

Liabilities

Net Worth

Cash Availability

Other Questions