Facing Page-Uniform Franchise Registration Application
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Facing Page-Uniform Franchise Registration Application Form. This is a Virginia form and can be use in Blue Sky Secretary Of State.
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Form A – Uniform Franchise Registration Application
7/01/08
UNIFORM FRANCHISE REGISTRATION APPLICATION
File No.
(Insert file number of immediately
preceding filing of Applicant)
State:
Fee:
APPLICATION FOR (Check only one):
INITIAL REGISTRATION OF AN OFFER AND SALE OF FRANCHISES
RENEWAL APPLICATION OR ANNUAL REPORT
PRE-EFFECTIVE AMENDMENT
POST-EFFECTIVE MATERIAL AMENDMENT
1.
Full legal name of Franchisor:
2.
Name of the franchise offering:
3.
Franchisor’s principal business address:
4.
Name and address of Franchisor’s agent in this State authorized to receive service of
process:
5.
The states in which this application is or will be shortly on file:
American LegalNet, Inc.
www.FormsWorkflow.com
Form A (cont’d) – Uniform Franchise Registration Application
6.
Page 2
Name, address, telephone and facsimile numbers, and e-mail address of person to whom
communications regarding this application should be directed:
Certification
I certify under penalty of law that I have read and know the contents of this application, including the
Franchise Disclosure Document with an issuance date of
attached as an exhibit,
and that all material facts stated in all those documents are accurate and those documents do not contain
any material omissions. I further certify that I am duly authorized to make this certification on behalf of
the Franchisor and that I do so upon my personal knowledge.
Signed at
,
, 20
Franchisor:
By:
Name:
Title:
American LegalNet, Inc.
www.FormsWorkflow.com
