File# Area:

FINNEY AND DUPONT INC.
3660 - 61 Avenue S.E., Calgary, Alberta • T2C 2C7 Canada
Telephone: (403) 720-3866 • Fax: (403) 720-2953

PERSONAL INFORMATION FORM

Dear Prospective SURE Owner:

Thank you for your recent Franchise inquiry - it could be the first step in fulfilling the dream of becoming a successful independent business owner. A few minutes with the material enclosed herewith could change your life.

When you own a SURE franchise, you are in business for yourself... but with support and assistance just a phone call away. The SURE concept provides you with a full turnkey business operation without any surprise "extras", as well as initial and ongoing training and support at a very reasonable fixed monthly fee. Our turn-key package includes site identification, lease negotiation, all equipment listed, complete initial training and ongoing support and training.

We believe that a business decision such as this requires honesty and clear disclosures by both parties. Our brochure provides a summary of our background and operational practices. Please provide us with information about yourself by completing and returning the enclosed form so that we may gain a better understanding of your goals, desires and qualifications.

At SURE, we believe in working together in order to win together. We also believe that no one person is as smart as all of us combined.

We welcome you to contribute your powers and abilities for mutual gain as well as individual financial independence.

Yours truly,

PERSONAL INFORMATION

Full Name:

Spouse's Name:

Home Address:

City:

Province:

Postal Code:

Phone# Home:

Business:

I Wish to Operate My Business (Please Check)

As an owner operator	As an owner investor	With my spouse
With my children	With a partner	With a financial broker

EMPLOYMENT PROFILE

Present Job Title:

From:

To:

Duties:

Previous Job Title:

From:

To:

Duties:

Spouse's Present Job:

From:

To:

Duties:

Spouse's Previous Job Title:

From:

To:

Duties:

Additional Sources of Income:

Any Health Problems:

Spouse:

Do You:       Own

Rent

Market Value: $

What are your monthly payments?: $

Mortgage Balance:: $

EDUCATIONAL BACKGROUND

Yourself:
Spouse:

Where did you first hear of SURE?:

Are you familiar with any SURE stores in your area?:

What source created interest in our program?:

Why did you become interested in instant printing?:

GEOGRAPHIC AREA OF INTEREST (LIst where you would like to establish your business)

1st Choice:
2nd Choice:
3rd Choice:

At what stage do you consider yourself in purchasing a SURE Business Opportunity?

Mildly Interested

Very Interested

Ready to Purchase

By what date do you want to be in business? [Please check one]

60 Days

90 Days

120 Days

Other

What are your reasons for going into your own business?

Want to have greater control over my work, my career and my future

Want to build financial security for myself and my family

Have had enough of working for someone else, I want to be the boss

Want to have increase my income

Want to diversify my investments

Other (please explain)

What are some of the major questions and concerns you have about owning your own business?

1.
2.
3.
4.
5.

Financial References:

Bank:		Address:
Bank:		Address:
Trade:		Address:
Trade:		Address:

You may provide any additional information on your experience
and background which may be helpful in our review.

FINANCIAL INFORMATION

Cash available for investment (Savings, CD's, Stocks, Bonds, Other) Please indicate:

$10 - 15,000	$15 - 20,000	$20 - 25,000
$25 - 50,000	$50 - 100,000	Over $100,000

STATEMENT OF NET WORTH

Cash on Hand and in Banks $ Savings Accounts in Banks $ Canada and Provincial Bonds $ Accounts and Notes Receivable $ Life Insurance-Cash Surrender Value Only $ RRSP's $ Other Stocks and Bonds $ Real Estate $ Automobile - Present Value $ Other Personal Property $ Other Assets $ Total $

Accounts Payable $ Notes Payable to Banks $ Notes Payable to Others $ Installment Account - Automobile $ Monthly Payments: $ Installment Accounts $ Monthly Payments: $ Loans on Life Insurance $ Mortgages on Real Estate $ Unpaid Taxes $ Other Liabilities $ Total Liabilities $ Net Worth $ Total $

Contingent Liabilities: (As Guarantor, Co-Maker/Endorser):

This information is submitted by the undersigned for the purpose of procuring, establishing, and/or maintaining credit. The undersigned certifies that all the information inserted herein has been carefully read and is true, correct and complete. The undersigned authorizes SURE Graphics Limited or its agents to obtain verification of any of the above information and authorizes the release of such information to SURE or its agents.

		Signature:
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