PERSONAL DETAILS
First Name(*):
Last Name:
Date:
Your Email (*):
Gender:
Male
Female
US Citizen:
Yes
No
Permanent Address:
Social Security:
Home Address:
Home Phone Extension:
Work Phone:
Work Phone Extension:
City:
State / Province:
Zip / Postal Code:
Country:
How long at this address?:
Previous Address:
Previous City:
Previous State / Province:
Previous Zip / Postal Code:
Previous Country:
Birth Date:
Best Time To Call:
Home Ownership:
Own
Renting
Marital Status:
Single
Married
Spouse Name:
Spouse Social Security #:
Spouse US Citizen:
Own
Renting
Spouse Birth Date:
Franchise Focus
How many locations are you interested in?
List experiences and skills that would make you a
successful franchisee:
Which city would you like to place your franchise?
Please detail your understanding of franchising:
When would you be ready to start?
Please detail your greatest accomplishment to date:
Business and Management Experience & Goals
Present employer:
Title / Position
Dates employed:
Do you plan to devote time to this venture? If yes, please identify them
below and their ownership interests
Yes
No
Do you plan to have business partners?
Partner 1 phone number:
Partner 1 name:
Partner 1 percentage of interest:
Partner 1 email address:
Partner 2 phone number:
Partner 2 name:
Partner 2 percentage of interest
Partner 2 email address:
Financials
Investment and working capital ($)
Estimated net worth ($)
Source of capital?
Please list the three main questions you have about this business opportunity
Question 1
Question 2
Question 3
How did you hear about Colbert/Ball Tax Service?
What corporate representative assisted you in following through with this opportunity?
Would this business be your only source of income?
Yes
No
If no, please explain

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Lets get the
Ball rolling

tax services of the future

Colbert/Ball is in the business of providing opportunities for entrepreneurial minded people to acquire their own business.

CORPORATE OFFICE
2616 South Loop West - Suite 110
Houston, TX 77054 USA

1 (888) 288-8675
(713) 592-5555

franchise@colbertballtax.com

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