FRANCHISE AGREEMENT SUMMARY Form Instructions Applicant Name This is a person or legal entity listed in the “Entity or Individuals applying for the license” section of the LIQUOR LICENSE APPLICATION form. Business Name This is the name listed in the “trade name” section of the LIQUOR LICENSE APPLICATION form. City This is the city of the business location address. Franchisor Name List the name of the franchisor. This is the person or organization granting the franchise through a written franchise agreement. The franchise agreement gives the franchisee(s) the right to use such things as the trade name, trademarks, symbols, advertising, or trade secrets associated with the business. Franchisee Name(s) List the name(s) of the franchisee(s). This is the person or company that will operate the business and have the liquor license. If you are applying for the liquor license as a legal entity, like a corporation or limited liability company (LLC), the franchise agreement and the Franchise Agreement Summary must name the legal entity as the franchisee. Agreement Provide either a copy of the franchise agreement or a letter of intent. If the agreement is finalized, provide a signed and dated agreement. If the agreement is not finalized you may provide a draft copy. Applicant Signature A person authorized to sign as an applicant must sign and date this form. FAS Instructions (08/11) American LegalNet, Inc. www.FormsWorkFlow.com OREGON LIQUOR CONTROL COMMISSION FRANCHISE AGREEMENT SUMMARY This form will become part of your permanent record. Information must be printed legibly in dark ink, or typed. j Applicant Name:___________________________________________________________________ j Business Name:___________________________________________________________________ j City:_____________________________________________________________________________ j 1. Franchisor Name:________________________________________________________________ 2. Franchisee names, exactly as stated in the Franchise Agreement: j ________________________________________________________________________________ j ________________________________________________________________________________ j ________________________________________________________________________________ 1.00 3. Franchise initial fee: $_____________________________ 1.00 4. Inventory cost estimate: $__________________________ j $ $ $ 5. Franchise royalty fee:___________% of (choose one) ___net profit ____gross profit ___other j If you checked “other,” what is the basis? ____________________________________________ _ $ $ 6. Is the Franchisor loaning you any money to get this franchise? ____Yes ____No 1.00 If yes, how much? $_________________ $ $ 7. Is the Franchisor leasing or renting any property to you? ___Yes ____No $ If yes, what type is it? _____Real property $ ___Personal property I understand that if my answers are not true and complete, the OLCC may deny my license application. j Applicant Signature:______________________________________ ___ Date:_________________ j 1-800-452-OLCC (6522) www.oregon.gov/olcc (rev. American LegalNet, Inc. www.FormsWorkFlow.com )