FC Info Sheet - Final

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PERSONAL INFORMATION

Last Name, First Name, Middle Name


Biasura, Michelle Naing

Home Address House/Unit No., Floor & Bldg./Street, Lot/Blk,Brgy/Village,District/Town,City/Province,Country


320 Zamudio Street Cayanga San Fabian Pangasinan

Date of Birth (MM-DD-YYYY) Birth Place Age Citizenship Civil Status Gender

March 26 , 1977 Dagupan City 41 Filipino Married Female

Mobile No. Telephone No. Fax No. Email Address


09985936845 jobiasura@philseven.com
Spouse’s Name *Last Name, First Name, Middle Name Spouse’s Birth Date (MM-DD-YYYY)
Biasura, Jeffrey Olympia 07-03-1976
Children’s Names *Last Name, First Name, Middle Name Birth Date (MM-DD-YYYY) Age Gender

1 ______Biasura, Jhazreel Mae_________________________________Aug 1, 2000________________ 17___ __ Female


___________
2 ______Biasura, Julianne Marie_______________________________Apr 16, 2003 15 Female
__________________________________________________________
3 ______Biasura, Mary Cloe Biasura___________________________Feb 17, 2010_______________ 7 Female
______ ________________________________________
4 ______Biasura, Jeffrey Jr,_________________________________ Nov 27, 2012 5 Male
5 ________________________________________________________
EDUCATIONAL ATTAINMENT
APPLICANT SPOUSE

Doctorate Doctorate

Master’s Degree Master’s Degree

x College Degree x College Degree

Associate Degree Associate Degree

High School Graduate High School Graduate

Elementary Graduate Elementary Graduate

No Formal Schooling No Formal Schooling


*Kindly check highest educational attainment. Also, please specify name of school.
ID/s Presented:

TIN ID ____260-399-464______________________________

*Please attach at least two (2) gov’t issued IDs. October 2017

STORE OPERATOR’S INFORMATION SHEET


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(HIGHLY CONFIDENTIAL)
REAL ESTATE PROPERTIES AND OTHER ASSETS AVAILABLE FOR THE FRANCHISE BUSINESS
(under FC’s name only)

TYPE PERSONALLY OWNED/ RELATION LOCATION SIZE (sqm)

OWNED BY RELATIVES*

House & Lot _____Personally _Owned_ _________________San Fabian , Pangasinan ______240sqm__


____________________ _________________ _______________ ____________
Vacant Lot ___________________________ __________________ _______________ ____________
___________________________ __________________ _______________ ____________

Vehicle ___________________________ __________________ _______________ ____________


___________________________ __________________ _______________ ____________
*Indicate if: Personally Owned (PO) or Owned y Relatives (OR)
A. Have you, your spouse or any of your immediate family members ever owned and/or operated your/their own business?

Yes x No If yes, please give details by completing Annex “A”.

B. Do you anticipate your immediate family member or relatives to work with you in operating the store?

x Yes No

If yes, please specify:

Name of Person Relationship Age In what capacity

___Irish L, Soriano______________________________cousin_________ __________24___________ _Store Staff__________


_______________________________

__________________________________________ _____________________ ___________ _______________________________

__________________________________________ _____________________ ___________ _______________________________

__________________________________________ _____________________ ___________ _______________________________

__________________________________________ _____________________ ___________ _______________________________

BUSINESS/EMPLOYMENT REFERENCES
______________________________________________________
Name and address of at least three (3) business associates or current or previous employer:
Name Position Co. Name & Address Tel. No.

1 ____________________________________________________________________________________________ _____________________
2____________________________________________________________________________________________ _____________________
3 ____________________________________________________________________________________________ _____________________
4____________________________________________________________________________________________ _____________________
Membership in various professional, business or civic organization:
Name of Organization Position Length of Membership
1______________________________________________________ __________________________________ Page 2 of 5
___________________________
ANNEX “A”
BUSINESS/EMPLOYMENT PROFILE OF APPLICANT, SPOUSE OR IMMEDIATE FAMILY MEMBERS.
Please give details of business you owned and/or run you have been employed with for the last 5 years. (OPERATIONAL)
A. Applicant:

Business/Company Name _______________________________________________________________________


Main Products/Services _______________________________________________________________________
Address/Tel. No. _______________________________________________________________________
Period of Involvement _________________________ Position _____________________________
Current Status of such business _______________________________________________________________________

Business/Company Name _______________________________________________________________________


Main Products/Services _______________________________________________________________________
Address/Tel. No. _______________________________________________________________________
Period of Involvement _________________________ Position _____________________________
Current Status of such business _______________________________________________________________________

B. Spouse:

Business/Company Name _______________________________________________________________________


Main Products/Services _______________________________________________________________________
Address/Tel. No. _______________________________________________________________________
Period of Involvement _________________________ Position _____________________________
Current Status of such business ________________________________________________________________________

Business/Company Name _______________________________________________________________________


Main Products/Services _______________________________________________________________________
Address/Tel. No. _______________________________________________________________________
Period of Involvement _________________________ Position _____________________________

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FINANCIAL PROFILE

P400,000.00
Please indicate the amount of capital you can make available for this business.

If you need additional funds for the business, how much additional funds would you need?

Will the business be your sole source of income? Yes x No


BANK REFERENCES:
BANK Type of Account How Long Account Held
1 __________BPI___________________________ _Savings account________________
__________________________________ ___________________________
2 ______________________________________________________ __________________________________ ___________________________
3 ______________________________________________________ __________________________________ ___________________________

CREDIT CARD REFERENCES:

CARD COMPANY Type of Card Card Limits


1 ______________________________________________________ __________________________________ ___________________________
2 ______________________________________________________ __________________________________ ___________________________
3 ______________________________________________________ __________________________________ ___________________________
FINANCIAL INFORMATION
ASSETS LIABILITIES
1. Cash on hand and in banks Php100, 000.00____________ 12. Outstanding Loans (car loans, etc) Php___ ______

(Checking, savings, etc.) 13. Credit Cards – total balance payable Php __ ______

2. Stocks and bonds Php_____________ 14. Total Mortgage- Primary Residence Php_ ______

3. Value of Real Estate, Primary Residence Php___1M__________ 15. Mortgage due on other Real Estate Php__ ______

4. Value of other Real Estate Php_____________ 16. Other Liabilities – Attach List

5. Other Assets (student loans, 2nd mortgage, etc.) Php___ _____

Attach list (i.e. IRA, 401k, CD, etc.) Php_____________ 17. Total Liabilities Php________ ______

6. Total Assets (add lines 1 to 5) Php_____________

MONTHLY INCOME NET WORTH

7. Salary(ies), Wages or Commissions Php_____________ 18. Net Worth (subtract line 17 from line 6)Php__ __ ___

8. Real Estate Income (Rental Property) Php_____________ (Note: A complete financial statement will be

9. Other Income – Attach List Php_____________ required prior to qualifying for a 7-Eleven franchise)

(i.e. Annuity, child support, etc.)

10. Total Current Monthly Income Php_____________

(add lines 7 to 9)
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MONTHLY EXPENSES INVESTMENT
October 2017

Do you intend to own/control the franchise business all by yourself, or do you have other investment partners in mind?

Sole Ownership / Control

x With partner/ Investor

Family member or Outsider


Would you have other partners to argument your existing capital?

Yes x No

PLEASE SKETCH A MAP OF YOUR HOME ADDRESS BELOW.

KINDLY INDICATE LANDMARKS AND STREET NAMES

I hereby represent that all of the above answers are true and complete to the best of my knowledge and belief. As proof,
attached herewith are copy of my two (2) government released ID’s.

Michelle Naing Biasura


APPLICANT’S SIGNATURE OVER PRINTED NAME
Date: _May 17 , 2018 ______

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