Fill and Sign the Controlling Persons Questionaire Form

FF 10/96© STP 1020-1 Form 1.02 Controlling Persons Questionaire BIOGRAPHICAL INFORMATION FORM NOTE: Each person who is one of the following for the franchisor company should fill out and sign this form: Director, Principal Officers, other Executives who will manage franchisees, and Franchise Brokers/Sales Agents 1. Name: 2. Current Title/Position with Franchisor: 3. Birthdate: 4. Social Security No.: 5. Residential Address: 6. Residential Phone Number: 7. Business Address: 8. Business Phone Number: Form 1.02 1020-2© STP FF 10/96 9. Beginning with the date you started the job you held six years ago, on the chart be low please list your dates of employment, your employer(s), and your position(s) held from then to the present ( please be sure to include your present employer, job title and start date ): Employer JobTitle Location (City, State) Start Date (Mo/Yr) End Date (Mo/Yr) [FORM CONTINUES NEXT PAGE] Form 1.02 FF 10/96© STP 1020-3 10. Have you been convicted of a felony or pleaded nolo contendere to a felony charge involving a violation of a franchise law, fraud, embezzlement, fraudulent conversion, restraint of trade, unfair or deceptive practices, misappropriation of property or comparable allegations? Yes Error! Switch argument not specified. No Error! Switch argument not specified. 11. Have you been convicted of a misdemeanor or pleaded nolo contendere to a misdemeanor charge involving a violation of a franchise law, fraud, embezzlement, fraudulent conversion, res traint of trade, unfair or deceptive practices, misappropriation of property or comparable allegations? Yes Error! Switch argument not specified. No Error! Switch argument not specified. 12. Have you been a party to any civil action, administrative action, complaint or legal proceeding involving a violation of a franchise law, fraud, embezzlement, fraudulent conversion, res traint of trade, unfair or deceptive practices, misappropriation or property or comparable allegations? Yes Error! Switch argument not specified. No Error! Switch argument not specified. 13. Are you a party to any proceeding which could make you subject to or are you subject to an injunction or restraining order brought by any public agency or department? Yes Error! Switch argument not specified. No Error! Switch argument not specified. 14. Have you been a party in any arbitration proceeding during the past 5 fiscal years of the corporation? Yes Error! Switch argument not specified. No Error! Switch argument not specified. 15. Have you filed in bankruptcy; been adjudicated a bankrupt; been reorganized due to insolve ncy; or been a principal, director, executive officer, trustee or general partner or any other e ntity that has filed in bankruptcy, been adjudicated a bankrupt, or been reorganized due to insolvency? Yes Error! Switch argument not specified. No Error! Switch argument not specified. 16. If your answer to any of the above items number 10-15 is in the affirmative, on an at tached sheet please state the court, the date of conviction or judgment, if any; the current status of the matter; any penalty imposed or damages assessed; and the date, nature, and issue of any order, as well as any other explanatory information you think pertinent. Name: Signature: Date: FF 10/96© STP 1020-4 THIS PAGE MUST BE KEPT AS THE LAST PAGE OF THE DOCUMENT.