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Application Form

Nando’s Page 1

ANNEXURE

PROSPECTIVE FRANCHISEE INITIAL APPLICATION FORM

Application Form

Nando’s Page 2

SECTION A

NEW NANDO’S BUSINESS DETAIL

Managed by whom (Full-time) Complete Section B1

Date available for training:

Geographical preference 1 2 3

Do you intend involving a partner? Yes No If yes, such a person must also complete an application form.

Name of partner/s

Each partner to complete Section B2

individually

If yes, state approximate

shareholding

Self % Partner

Name %

Note:

Both parties must complete Section C – Section F and both parties must sign the Application Form.

Application Form

Nando’s Page 3

PERSONAL DETAILS OF THE MANAGING OWNER/OPERATING PARTNER

Note: 1. This section is to be completed by the individual who will be responsible for the day-to-day management of the franchised store.

2. Please attach a copy of your I.D. Document as well as a recent photograph of yourself together with your up-to-date Curriculum

Vitae.

3. Nando’s policy dictates that the Managing Owner must hold a minimum of 30% shares in the trading entity.

Surname

First names

Place of birth Nationality

Date of birth ID Number

Residential address

Code

Postal address

Code

Telephone (Business) Telephone (Home)

Cell e-mail address

Permanent SA Citizen Yes No Fax no

At present address Years Months Residential Property is Owned Rented

Marital Status

Single Y N If

Married

In community

of property

Out of community of

property

ANC without

Accrual

If divorced Final Yes No Date Final

If widow/er Other

(Include copy of Contract if married ANC, copy of divorce decree)

If married please supply the following additional information about your spouse

First names



Name of employer

Employer address

Code

Employers telephone

Present position Annual Income

Number of dependents Number of children Their ages

Does your spouse understand the business risks and potential rewards involved? Yes No

Do your spouse and family understand the extra demands that a new business will make

in relation to your time and effort, especially in the establishment phase of the business? Yes No

SECTION B1

Application Form

Nando’s Page 4

Employment history

Employer From To Type of work Last position held Annual income

1.

2.

3.

(Kindly include a CV)

Education

Highest standard

passed.

Year

Do you have a

degree or diploma

If YES, specify

Formal

apprenticeships or

pupilage?

If YES, specify

Do you have any

formal business skills?

If YES, specify

Medical information

Being the owner of a Nando’s Franchise involves manual and mental pressures. Please provide the following

information to assist us in ensuring that you are capable of meeting such requirements.

What is your general state of health? Excellent Very Good Good Poor

Is there any additional information regarding your general state of health that may impact on

your ability to be a Nando’s Franchisee?

If yes, please give details.

Details of next of kin

Name and residential address of next of kin (not of the same address) Relationship:

Name

Address

Code

Telephone

Application Form

Nando’s Page 5

Details of primary cheque/credit card/savings account

Type of account Bank/Institution Account Number Date Opened Limits

Self

1. Cheque

2. Credit card

3. Savings

Spouse

1. Cheque

2. Credit Card

3. Savings

Current accounts (If none, recently settled accounts)

Institution/Business Branch Account Number Balance Present limit

1.

2.

3.

4.

Credit record

Have you ever had any judgments against you (are you blacklisted)? Yes No If YES, specify details

Have you ever been sequestrated? Yes No If YES, specify details

Date

Have you ever been found guilty of a criminal offence Yes No If YES, specify details

Application Form

Nando’s Page 6

Statement of Assets and Liabilities

ASSETS (Amount in Rand) (A)

1. Fixed Property registered in your name

City and Town property Owners Valuation Bank Use

Erf no City/Township Purchase Price Date Purchased Fire Insurance

Farm and Smallholding property Owners Valuations Bank Use

Erf no

Name of

farm

City/Township Purchase Price Date Purchased Fire Insurance

Property bought under deed of sale

Erf no

Name of

farm

City/Township Purchase Price

2. Mortgage Bonds in own favor, i.e. where a bond is held over the

fixed property of another person. State first or subsequent bond(s)

and give a description of property. State the amount outstanding

still receivable.

3. Stock (specify)

4. Vehicles (State the model and year)

5. Miscellaneous movable property (specify)

6. Debtors (state the name)

7. Shares/Loans (specify)

Listed on the JSE

Unlisted shares/Loans to private companies

8. Other investments and assets (specify)

Application Form

Nando’s Page 7

9. Life policies (surrender values, if known)

Insurance Company Policy number Life cover Ceded to Surrender Value

10. Credit balances (e.g. savings accounts, fixed deposits, etc.)

TOTAL ASSETS (A)

Liabilities (Amounts in Rand) (B) Amount

Liabilities stated as on

1. Mortgage bonds (for amounts due under deed of sale)

Erf no/ Name of farm Town/City Bondholder/Seller Interest Rate Installment Expiry date

Sub Total

2. Term loans, personal loans (specify)

3. Owing under installment sale agreements

Type of asset e.g. vehicle, machinery, etc At which institution Installments Monthly

4. Income tax owing (state when due)

5. Owing to banks (state names and specify liabilities)

6. Owing in respect of credit cards (specify)

7. Other liabilities (describe and mention terms and conditions of repayment

TOTAL LIABILITIES (B)

VALUE A – B

NOTARIAL BONDS (state over which assets and in favor of whom)

Application Form

Nando’s Page 8

CONTINGENT LIABILITY

1. Leases

Item Financed by Outstanding amount Installment Date payable

2. Suretyship

In Favor At Financial Institution Details of security provided Amount

Monthly income Self Spouse Monthly Expenditure

Gross salary R R Bond repayments/Rent R

Housing subsidy R R HP/Loan/Credit Card R

Car allowance R R Insurance (Life and Short term) R

Commission R R Domestic (water, lights, rates) R

Overtime R R School and University Fees R

Other (specify) R R Transport R

Other (specify) R R Maintenance (if divorced) R

Other (specify) R R Subtotal (fixed expenses) R

Other (specify) R R Other (specify) R



TOTAL INCOME R R Other (specify) R

Less: Pension/Medical

aid/PAYE

R R Other (specify) R

NET INCOME R R TOTAL EXPENSES R

Description of security

Type of security Available

(x)

Value Owned Bank Use

First covering mortgage bonds – residential

Continuing covering mortgage bonds where another financial

intuition or any other party holds prior ranking bonds. NB.

Consent of existing bondholder Essential.

Cession of listed shares on the JSE excluding any shares listed in

the Development Capital or Venture Capital Sections of the JSE

Pledged Kruger Rands

Cession of fixed deposit

Cession of unit trust

Cession of life policy (Surrender value)

Other (specify)

1.

2.

3.

Application Form

Nando’s Page 9

References

Note:

By your signature to this form, you are authorizing Nando’s to perform whatever credit checks they may consider necessary in their assessment

of the application.

Bankers

Branch

Telephone No. ( )

Contact Person/Manager

Account No.

Other references:

1. Name

Address

Telephone No ( )

Position/Relationship

2. Name

Address

Telephone No ( )


3. Name

Address

Telephone No. ( )


4. Name

Address

Telephone No. ( )


5. Name

Address

Telephone No. ( )


6. Name

Address

Telephone No. ( )


___________________________ ___________________________ ____________________________________________

Date Name Signed by:

Managing owner/Operating partner

Application Form

Nando’s Page 10

DETAILS OF OTHER STAKE HOLDERS

Note:

1. A copy of this section must be made for all partners, members or shareholders (who are not the Managing Owner of the

business) and fully completed by each party.

2. Please attach a copy of your I.D. Document and a recent photograph of yourself.

In what capacity is this section being completed?

(tick one or more blocks as applicable)

Fully active partner/member/shareholder

Partially active partner/member/shareholder

Investor

Surname

First names



Residential address

Code

Postal address

Code

Telephone (Business) Telephone (Home)

Cell e-mail address

Permanent SA Citizen Fax no

At present address Years Months Residential Property is Owned Rented

Marital Status

Single Y N If Married In community

of property

Out of community of

property

ANC without

Accrual

If divorced Final Yes No Date Final

If widow/er Other

(Include copy of Contract if married ANC, copy of divorce decree)

If married please supply the following additional information about your spouse

First names



Name of employer

Employer address

Code

Employers telephone

Present position Annual Income

Number of dependents Number of children Their ages

SECTION B2

Application Form

Nando’s Page 11

Does your spouse understand the business risks and potential rewards involved? Yes No

Do your spouse and family understand the extra demands that a new business will make

in relation to your time and effort, especially in the establishment phase of the business?

Yes No

Medical information

Being the owner of a Nando’s Franchise involves manual and mental pressures. Please provide the following

information to assist us in ensuring that you are capable of meeting such requirements.

What is your general state of health? Excellent Very Good Good Poor

Is there any additional information regarding your general state of health that may impact on

your ability to be a Nando’s Franchisee?

If yes, please give details.

Details of next of kin

Name and residential address of next of kin (not of the same address) Relationship:

Name

Address

Code

Telephone

Employment history

Employer From To Type of work Last position held Annual income

1.

2.

3.

4.

(Kindly include a CV)

Education

Highest standard passed Year

Do you have a degree or diploma If YES, specify

Formal apprenticeships of pupilage? If YES, specify

Do you have any formal business skills? If YES, specify

Details of primary cheque/credit card/savings account

Type of account Bank/Institution Account Number Date Opened Limits

Self

1. Cheque

2. Credit card

Application Form

Nando’s Page 12

3. Savings

Spouse

1. Cheque

2. Credit Card

3. Savings

Current accounts (If none, recently settled accounts)

Institution/Business Branch Account Number Balance Present limit

1.

2.

3.

4.

Credit record

Have you ever had any judgments against you (are you blacklisted)? Yes No If YES, specify details

Have you ever been sequestrated? Yes No If YES, specify details

Date

Have you ever been found guilty of a criminal offence Yes No If YES, specify details

Statement of Assets and Liabilities

ASSETS (Amount in Rand) (A)

1. Fixed Property registered in your name

City and Town property Owners Valuation Bank Use

Erf no City/Township Purchase Price Date Purchased Fire Insurance

Farm and Smallholding property Owners Valuations Bank Use

Erf no

Name of

farm

City/Township Purchase Price Date Purchased Fire Insurance

Property bought under deed of sale

Erf no

Name of

farm

City/Township Purchase Price

2. Mortgage Bonds in own favor, i.e. where a bond is held over the

fixed property of another person. State first or subsequent bond(s)

and give a description of property. State the amount outstanding

still receivable.

3. Stock (specify)

Application Form

Nando’s Page 13

4. Vehicles (State the model and year)

5. Miscellaneous movable property (specify)

6. Debtors (state the name)

7. Shares/Loans (specify)

Listed on the JSE

Unlisted shares/Loans to private companies

8. Other investments and assets (specify)

9. Life policies (surrender values, if known)

Insurance Company Policy number Life cover Ceded to Surrender Value

10. Credit balances (e.g. savings accounts, fixed deposits, etc.)

TOTAL ASSETS (A)

Liabilities (Amounts in Rand) (B) Amount

Liabilities stated as on

1. Mortgage bonds (for amounts due under deed of sale)

Erf no/ Name of farm Town/City Bondholder/Seller Interest Rate Installment Expiry date

Sub Total

2. Term loans, personal loans (specify)

3. Owing under installment sale agreements

Type of asset e.g. vehicle, machinery, etc At which institution Installments Monthly

Application Form

Nando’s Page 14

4. Income tax owing (state when due)

5. Owing to banks (state names and specify liabilities)

6. Owing in respect of credit cards (specify)

7. Other liabilities (describe and mention terms and conditions of repayment

TOTAL LIABILITIES (B)

NET ASSET VALUE (A – B )

NOTARIAL BONDS (state over which assets and in favor of whom)

CONTINGENT LIABILITY

1. Leases

Item Financed by Outstanding amount Installment Date payable

2. Suretyship

In Favor At Financial Institution Details of security provided Amount

Monthly income Self Spouse Monthly Expenditure

Gross salary R R Bond repayments/Rent R

Housing subsidy R R HP/Loan/Credit Card R

Car allowance R R Insurance (Life and Short term) R

Commission R R Domestic (water, lights, rates) R

Overtime R R School and University Fees R

Other (specify) R R Transport R

Other (specify) R R Maintenance (if divorced) R

Other (specify) R R Subtotal (fixed expenses) R




TOTAL INCOME R R Other (specify) R

Less: Pension/Medical

aid/PAYE

R R Other (specify) R

NET INCOME CC DRAWINGS R TOTAL EXPENSES R

Application Form

Nando’s Page 15

Description of security

Type of security Available (x) Value Owned Bank Use

First covering mortgage bonds – residential

Continuing covering mortgage bonds where another financial

intuition or any other party holds prior ranking bonds. NB. Consent

of existing bondholder Essential.

Cession of listed shares on the JSE excluding any shares listed in

the Development Capital or Venture Capital Sections of the JSE

Pledged Kruger Rands

Cession of fixed deposit

Cession of unit trust

Cession of life policy (Surrender value)

Other (specify)

1.

2.

3.

Application Form

Nando’s Page 16

References

Note:

By your signature to this form, you are authorizing Nando’s to perform whatever credit checks they may consider necessary in their assessment

of the application.

Bankers

Branch

Telephone No. ( )

Contact Person/Manager

Account No.

Other references:

1. Name

Address

Telephone No ( )


2. Name

Address

Telephone No ( )


3. Name

Address

Telephone No. ( )


4. Name

Address

Telephone No. ( )


5. Name

Address

Telephone No. ( )


6. Name

Address

Telephone No. ( )


___________________________ ___________________________ ____________________________________________

Date Name Signed by:

Other shareholder

Application Form

Nando’s Page 17

General proposal overview

Note: With all the shareholders having discussed the questions below, please insert your agreed response

Why have you selected Nando’s as a business opportunity and not any other franchise business?

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

From your limited knowledge of the system, please give us your overview of the positive and negative aspects of

the Nando’s brand and system as you see it.

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

What research have you undertaken?

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

What was the outcome of your own investigation of the Nando’s brand?

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

Have you contacted any existing franchisees for input? If not, please specify why and if you have done so, what

was the outcome of your discussions?

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

How would you interpret the business risk associated with this proposal bearing in mind the information contained

herein?

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

________________________________________________________________________________________________________________

SECTION C

Application Form

Nando’s Page 18

DECLARATION & DISCLAIMER

Do you or have you ever had any interest in any other business Yes No

If YES, please supply the following details:

Name of business :

Nature of business:

Period of existence:

Intended Financing

Means R Source (and contact at Bank, if applicable)

Own cash

Partners cash contribution

Do you apply for a business loan? Yes No

Please attach a copy of your ID document with this application (this applies to owner manager and All investors)

I submit the following information as a complete and true personal record at the time of the date shown below. I

understand that Chickenland (Pty) Ltd is relying upon all the above information as a material factor in

considering my application to become a franchisee of their group and therefore agree to promptly notify

Nando’s of any material change in any of the above information or any subsequent information provided by

Nando’s.

Furthermore, by your signature to this application, Chickenland (Pty) Ltd and/or their duly appointed

representatives are authorised to perform whatever credit checks they consider necessary in the assessment of

the application.

The undersigned certify that the information provided is true and correct.

SECTION D

Application Form

Nando’s Page 19

I declare that I have received and read Nando’s brochure

I acknowledge the fact that this application does not bind or obligate any party in any manner.

Signed at ________________ on this ___ day of ______________________200 _

_______________________________

Signature of Owner/Manager

WITNESSES:

______________________________

______________________________


_______________________________

Signature of other Shareholder/s

WITNESSES:

______________________________

______________________________

Please e-mail to: [email protected]

Or send to: Nando’s

P.O. Box 53618

Troyville

2139

Or fax to 27 11 216 3302

Application Form

Nando’s Page 20

BUSINESS LOAN

I intend to finance the complete set – up cost of the franchise with my own funds Yes No

I shall apply for a business loan myself at a financial institution of my own choice Yes No

I request Nando’s for guidance to which financial institution this application must be

forwarded

Yes No

If yes, then you must sign the acknowledgement and consent hereunder Yes No

If any of the finance options is applied for, the approval or refusal of the application is within the sole discretion of

the financial institution. This financial institution will provide you with a facility letter or letter of approval setting

forth the full details of the financing granted, security to be furnished, cost involved and related matters.

SECTION E

Application Form

Nando’s Page 21

ACKNOWLEDGEMENT AND CONSENT BY APPLICANT

(This consent is required in terms of the Code of Banking Practice relating to obtaining written consent for

verification of information provided for during the lending assessment process).

I hereby irrevocably:

Authorize the financial institution selected by Nando’s to contact any of the referees (including but not limited to

banks or auditors), mentioned in this application form and to obtain any additional information which the financial

institution, in it sole discretion, may deem necessary;

I hereby declare the information provided in this application form is to the best of my knowledge true, correct and

accurate in all material respects.

I acknowledge that failure to disclose any information that are relevant to this application, or the furnishing/

provision of any untrue, incorrect or inaccurate information will render this application or any agreement or

subsequent agreement entered into between the franchisor and myself (either personally or on behalf of any CC or

Company) or myself and the financial institution, null and void.

I herewith declare that the amount as stated in the application as own contribution has not been borrowed from

any source where it is repayable in the future or where it may cause any financial liability to the business.

I further acknowledge that this application does not constitute any form of agreement or contract whatsoever

between the franchisor, the financial institution and myself, and is no way binding on either party. However, if any

finance is granted to me as a result of this application, the information contained herein will throughout the duration

thereof form the basis for such financing.

I authorize the financial institution to disclose full particulars regarding the approval of my application to Nando’s.


_______________________________

APPLICANT WITNESSES:

1. ____________________________

2. ____________________________