Confidential Questionnaire – Financial Information

All information will be held strictly confidential.
If there will be more than one owner of the franchise, each must also complete a personal financial statement.
Your Net worth should exceed $100,000 for a franchise.

* The security of your data and information is very important to us.  This form is transmitted to us through a secure, encrypted connection protected by a Secure Socket Layer (SSL) certificate.  For additional security, Criterium’s network is monitored 24/7 by a third-party security team.

Phone: (800) 242-1969
Website: https://theengineeringfranchise.com
Email: franchising@criterium-engineers.com

"*" indicates required fields

Name*
Will this franchise be your primary source of income?*
Are you planning to finance this franchise?*

What personal (net) income do you expect in:

Have you, your spouse, or your business ever been involved involved in bankruptcy, insolvancy, or compromise with creditors?*

ASSETS

LIABILITIES

CURRENT SOURCES OF INCOME

CAPITAL AVAILABLE TO INVEST

By signing below I affirm that all of the data contained herein is a true representation of my personal and financial condition. If necessary, Criterium Engineers may obtain a copy of my credit report or other information as necessary.

Agreement*
Name*
Date*