§200.ILLUSTRATION C. Franchisee's Petition For Release of Escrowed Funds

 

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	)	SS
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IN THE MATTER OF:

FRANCHISOR:

FRANCHISEE:

 

BEFORE THE ATTORNEY GENERAL OF ILLINOIS

AS ADMINISTRATOR FOR THE FRANCHISE DISCLOSURE ACT

 

The undersigned franchisee hereby requests the Administrator to authorize release from
escrow the sum of $				, plus accrued interest representing the franchise fee paid
by me on the			day of		,		.

 

The undersigned franchisee hereby represents that the franchisor has not fulfilled the initial obligations owed to me under the franchise and other agreements and that I have not commenced doing business.

 

					Franchisee Signature
					Printed Name of Franchisee
					Address of Franchisee
Subscribed and sworn to before me this
		day of		,
		.
	Notary Public

 

(Source:  Amended at 23 Ill. Reg. 11561, effective September 7, 1999)