Form C - Uniform Franchise Consent to Service of Process UNIFORM FRANCHISE CONSENT TO SERVICE OF PROCESS (Name of Franchisor ,a (Form of entity) organized under the laws of (state of formation) (The "Franchisor"), irrevocably appoints the officers of the States designated below and their successors in those offices, its attorney in those State for service of notice, process or pleading in an action or proceeding against it arising out of or in connection with the sale of franchises, or a violation of the franchise laws of that State, and consents that an action or proceeding against it may be commenced in a court of competent jurisdiction and proper venue within that State by service of process upon this officer with the same effect as if the undersigned was organized or created under the laws of that State and had lawfully been served with process in that State. We have checked below each state in which this application is or will be shortly on file, and provided a duplicate original bearing an original signature to each state. -- California: Commission of Corporations -- Hawaii: Commissioner of Securities -- Illinois: Attorney General -- Indiana: Secretary of State -- Maryland: Securities Commissioner -- Minnesota: Commissioner of Commerce -- North Dakota: Securities Commissioner -- Rhode Island: Department of Business Regulation -- South Dakota: Director of the Division of Securities -- Virginia: Clerk, Virginia State Corporation Commission -- Washington: Director of Financial Institutions -- Wisconsin: Administrator, Division of Securities, Department of Financial Institutions -- New York: Secretary of State Please mail or send a copy of any notice, process or pleading served under this consent to: (Name and address) Dated:_____________________,20__. Franchisor: By: Name: Title: Sworn to before me this __ day of _____________ 20__ -----------------------------------______________________ American LegalNet, Inc. www.FormsWorkFlow.com Notary Public Commission Expires: Instructions for Preparing Form C - Uniform Franchise Consent to Service of Process 1. The Uniform Franchise Consent to Service of Process form should accompany each initial or renewal filing. Do not use with amendments. 2. Insert the correct legal name of the franchisor, the type of entity it is (e.g., corporation, limited liability company, etc.), and the state of formation. 3. Check the line for each state in which the Application will be filed. 4. Insert the name and address of the person to whom the Franchise Filing State should provide a copy of any notice, process or pleading served on the state agency. 5. Insert the date of signing. 6. In the signature block, insert the correct legal name of the franchisor, and print or type the name and title of the authorized signer. The authorized signer should sign on the "By:" line. 7. Provide an original signed copy. American LegalNet, Inc. www.FormsWorkFlow.com