Online Franchise Application

SpeeDee Oil Changes & Auto Service™ logo


Fields marked with * are mandatory.


Personal Information
First Name : Last Name : Date : Email : Gender : MaleFemale US Citizen : YesNo Present Address : Social Security # : Home Phone : Home Phone Extension : Work Phone : Work Phone Extension : City : Country : State / Province : *Zip / Postal Code : How long at this address? (Yrs) : Previous Address : City : Country : State / Province : Zip / Postal Code : Birth Date : Best Time To Call : Home Ownership : OwnRenting Marital Status : SingleMarried Spouse Name : Spouse Social Security # : Spouse US Citizen : YesNo Spouse Birth Date : US Military Veteran ? : YesNo Spouse Email : Spouse Phone :


Assets and Liabilities
ASSETS LIABILITIES Cash on Hand & in Banks ($) : Mortgages ($) : Marketable Securities ($) : Accounts Payable ($) : Accounts / Notes Receivable ($) : Notes Payable ($) : Retirement Plans ($) : Loans On Life Insurance ($) : Real Estate ($) : Credit Cards (total balance) ($) : Personal Property ($) : Unpaid Taxes ($) : Business Holdings ($) : Other Liabilities ($) : Other Assets ($) : Description : Description : Total Liabilities ($) : Total Assets ($) : Total Net Worth ($) :


Real Estate 1
Address : Date Purchased : Original Cost : Text Mortgage Balance : Present Value :


Real Estate 2
Address : Date Purchased : Original Cost : Present Value : Mortgage Balance :


Real Estate 3
Address : Date Purchased : Original Cost : Present Value : Mortgage Balance :


Annual Sources of Income
Salary ($) : Investment ($) : Real Estate Income ($) : Other ($) : Description : Total ($) :


Total Contingent Liabilities
Loan Co-signature : Legal Judgement : Income Taxes : Other Special Debt : Total :

Specific Data


If yes, please explain:

*What are the responsibilities of the Franchisor? :
*What are the responsibilities of the Franchisee? :
Why do you think this franchise will enable you to reach your personal goals? :
When would you be ready to invest in your franchise if you were approved ? :
What skills/experience do you have that will help you be successful in this business ? :
Have you been approved for financing? : YesNo
Who will be responsible for the daily operation of your store? :
Amount of cash available for investment? :
Do you have any contingent liabilities for guarantees, endorsements, leases etc ? : YesNo
Amount Approved ($) :
Would this business be your sole income source? : YesNo
Have you ever been convicted of a felony? : YesNo
Are you now, or have you ever been party to any lawsuit - either as defendant or plaintiff ? : YesNo
Have you ever been convicted of any offense (including misdemeanors for which you have fined $ 200 or more) ? : YesNo
Date Filed :
If so, explain :
Have you ever filed for bankruptcy? : YesNo
Date Discharged :


Area / Location Preferences
Preference 1 : Preference 2 : Preference 3 :


Please list the three main questions you have about this business opportunity
Question1 : Question2 : Question3 : Captcha ( Enter the text you see in the image below ) Captcha

Disclaimer

I hereby certify that all information herein contained is true and correct, to the best of my knowledge and understanding, and that any substantial error in fact may be reason for future recall of a Grease Monkey or SpeeDee Oil Change & Auto Service franchise, if awarded, as well as possible legal action for damage or inconvenience sustained as the result of said error in fact. This application does not obligate either party in any manner. I authorize Grease Monkey Franchising, LLC and SpeeDee Worldwide, LLC to perform whatever creditor or background check it deems necessary in reviewing my application.

*I Agree
Signature :