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Franchise Quarterly Sales Report Form. This is a Maryland form and can be use in Blue Sky Secretary Of State.
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OFFICE OF THE ATTORNEY GENERAL DIVISION OF SECURITIES 200 Saint Paul Place Baltimore, Maryland 21202-2020 (410) 576-6360 FRANCHISE QUARTERLY SALES REPORT Franchisors registered in the State of Maryland must file this report with the Division of Securitiesat the above address, pursuant to Section 02.02.08.14 of the Code of Maryland Regulations,promulgated under the Maryland Franchise Registration and Disclosure Law, Title 14, Subtitle 2,Business Regulation Article, Annotated Code of Maryland (1998 Replacement Volume). INSTRUCTIONS: Pursuant to the Rule cited above, quarterly sales reports must be filed with theCommissioner of Securities for each quarter beginning ninety (90) days after the effective date ofregistration, and each ninety (90) days thereafter. The quarterly sales reports must be filed no laterthan thirty (30) days after the end of each quarter. If, after the first year of registration, a franchisorfiles for renewal registration, additional forms will be provided. Md. File No._______________________________Franchisor:___________________________________________________________________ d/b/a:___________________________________________________________________ City/State/Zip:_________________________________________________________________ Telephone Number:____________________________________________________________ Current Effective Date of Registration:______________________________________________Dates covered by this report:___________________ to________________________________ Total number of franchises sold in Maryland and to Maryland residents during this period:_______________________________________________________________________ Name of franchise sales organization, if other than franchisor: ______ ________________________________________________ ______________________On the back of this page, please list for each franchise sold: 1. Name, address and telephone number of franchisee. 2. Selling price and date of sale of the franchise. 3. Attach a graphic representation of exclusive area(s) sold, if any. NOTE: WHEN THERE HAS BEEN NO ACTIVITY DURING THE 90 DAYS WHICH THIS REPORT COVERS, PLEASE SO INDICATE ON REPORT. >>>> 2LISTED BELOW ARE THE FRANCHISES SOLD DURING REPORTING PERIOD:Name of Franchisee ___________________________________________________________ Address ___________________________________________________________ ___________________________________________________________ Telephone ___________________________________________________________ Selling Price ___________________________________________________________ Date of Sale ___________________________________________________________ Name of Franchisee ___________________________________________________________ Address ___________________________________________________________ ___________________________________________________________ Telephone ___________________________________________________________ Selling Price ___________________________________________________________ Date of Sale ___________________________________________________________ Name of Franchisee ___________________________________________________________ Address ___________________________________________________________ ___________________________________________________________ Telephone ___________________________________________________________ Selling Price ___________________________________________________________ Date of Sale ___________________________________________________________ Name of Franchisee ___________________________________________________________ Address ___________________________________________________________ ___________________________________________________________ Telephone ___________________________________________________________ Selling Price ___________________________________________________________ Date of Sale ___________________________________________________________ Name of Franchisee ___________________________________________________________ Address ___________________________________________________________ ___________________________________________________________ Telephone ___________________________________________________________ Selling Price ___________________________________________________________ Date of Sale ___________________________________________________________ Name of Franchisee ___________________________________________________________ Address ___________________________________________________________ ___________________________________________________________ Telephone ___________________________________________________________ Selling Price ___________________________________________________________ Date of Sale ___________________________________________________________ Name of Franchisee ___________________________________________________________ Address ___________________________________________________________ ___________________________________________________________ Telephone ___________________________________________________________ Selling Price ___________________________________________________________ Date of Sale ___________________________________________________________ QUARTREP.FORM-2 revised 6/13/01