Fill and Sign the Justia Uniform Franchise Registration Application

FF 6/03© STP4150-1 Form 4.15Wisconsin WISCONSIN UNIFORM FRANCHISE REGISTRATION APPLICATION FILE NO. (Insert file number of previous filings of Applicant, if any) FEE: [Applicable Fee Amount] (Enclosed when application is initially filed) APPLICATION FOR (Check only one): REGISTRATION OF AN OFFER AND SALE OF FRANCHISESREGISTRATION RENEWAL STATEMENT OR ANNUAL REPORT AMENDMENT NUMBERTO APPLICATIONPOST-EFFECTIVEFILED UNDER SECTIONPRE-EFFECTIVEDATED1.Name of Franchisor. (If applicant is subfranchisor, the name of the subfranchisor.) Name under which the Franchisor is doing or intends to do business. 2.Franchisor's principal business address. Name and address of Franchisor's agent in the State of California authorized to receive process. Office of the Commissioner of Securities345 West Washington AvenueMadison, Wisconsin 537033.Name, address and telephone number of subfranchisors, if any, for this state.4.Name, address and telephone number of person to whom communications regarding this application should be directed. Form 4.154150-2© STPFF 6/03 UNIFORM CONSENT TO SERVICE OF PROCESS [Franchisor], a corporation organized under the laws of the State of , irrevocably appoints the Commissioner of Securities of Wisconsin and the successors in office, its attorney in the State of Wisconsin for service of notice, process or pleading in an action or proceeding against it arising out of or in connection with the sale of franchises, or a violation of the franchise laws of Wisconsin, and consents that an action or proceeding against it may be commenced in a court of competent jurisdiction and proper venue within Wisconsin by service of process upon this officer with the same effect as if the undersigned was organized or created under the laws of Wisconsin. It is requested that copy of any notice, process or pleading served this consent be mailed to: [Addressee listed on First Application Page, Item #4] Dated: , 20.[FRANCHISOR]By:_____________________________ [Signing Officer] Title: (SEAL) By: _____________________________ Title: