1. If your answer to question 25 is "yes", please provide the following information a. b. c. d. e. Date of filing: Date of discharge: Location of filing (state): The filing/action number of the filing: Parties to the filing: 27. Please provide on a separate sheet any other information you think may be relevant to your financial status. I CERTIFY THAT THE INFORMATION PROVIDED IN THIS CONFIDENTIAL QUESTIONNAIRE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE. I FURTHER AGREE THAT BY SIGNING BELOW, I AGREE THAT SHOULD THE ANSWER TO ANY QUESTION CHANGE, CONDITION CHANGE IN ANY M OR SHOULD MY FINANCIAL ATERIAL WAY THAT I WILL NOTIFY BOR FRANCHISING, LLC WITH A WRITTEN UPDATE. Signature Print Name: Date:

CREDIT AND CRIMINAL BACKGROUND CHECK RELEASE FORM

I understand that an initial and ongoing credit and criminal background check is a condition of being considered if I am to purchase a franchise from BOR Franchising, LLC Group, LLC. (BOR Franchising, LLC)

I consent to BOR Franchising, LLC obtaining my criminal conviction history from any law enforcement agency, criminal background service provider, municipality, state, and/or the FBI. I understand that BOR Franchising, LLC will obtain this information at the time I apply to become a franchisee and during the term of my franchise agreement. The criminal history record, as received from the reporting entity may include arrest and conviction data, plea bargains, deferred adjudication, as well as social security verification. It may also include information regarding driving history. I understand that I will have a limited opportunity to review the criminal history and a process is available for clarification if I dispute the record as received.

I further consent to BOR Franchising, LLC obtaining my credit history from all three credit reporting agencies. I understand that BOR Franchising, LLC will obtain this information at the time I apply to become a franchisee and during the term of my franchise agreement.

Source: Item 23 — Receipts (FDD pages 40–202)