Acknowledgement

I understand that the granting of a franchise is at the sole and absolute discretion of MyLoopCard Franchising, LLC ("Franchisor"). I understand that the submittal of this application is an initial step in the process towards qualification as a franchisee and in no way obligates Franchisor or applicant in any manner. Each owner, partner, member and shareholder associated with the applicant's purchase of the franchise must complete an application.

I understand that this application does not constitute an offer to sell a franchise, and that this information is being provided to Franchisor solely for the purpose of evaluating my personal, professional and financial qualifications, and that the information provided by me will be relied upon by the Franchisor as a material factor in considering my application to become a franchisee. I understand that such an offering is commenced only by Franchisor's delivery of a prospectus in compliance with the Federal Trade Commission Rule on Franchising and various state laws regulating the sale of franchised opportunities. Franchisor's acceptance or approval of this application shall not be considered as a grant of a franchise, we grant franchises only by executing a written Franchise Agreement.

I understand that the information I may receive from Franchisor relating to a franchise is confidential, has been developed with a great deal of effort and expense, is being made available to me because of this application, and shall be held in strict confidence. As such, I will not divulge or use any data, customer or employee names and addresses, techniques, methods, advertising materials, forms, or other information of whatever kind received from the Franchisor without its prior express written consent, which may be withheld in Franchisor's sole and absolute discretion.

I hereby authorize Franchisor to obtain a credit report or any other investigative consumer report and to contact references and other sources, including former employers, in order to obtain personal information about me. I understand that any credit or investigative consumer report may contain information about my background, character, general reputation, mode of living, credit worthiness, ability and job performance. I understand that, within a reasonable period following written request, I am entitled to additional information concerning the nature and scope of this investigation. I hereby release Franchisor, its affiliates, and their respective officers, agents, employees and servants from any liability arising from the receipt or use of information obtained through these sources and from any investigation relating thereto.

This authorization for release of information includes, but is not limited to, matters of opinion relating to my character, ability, reputation, criminal record and past performance. I hereby authorize all persons, schools, companies, corporations, past or present employers, credit bureaus, and law enforcement agencies to release such information without restriction or qualification to Franchisor, its affiliates, and any of their officers, agents, employees and servants. I voluntarily waive all recourse and fully release them from liability for complying with this authorization. This authorization/release shall apply to this as well as any future request for an investigative consumer report. I authorize that a photocopy or facsimile of this release be considered as valid as the original.

By signing below, I hereby certify that all of the information submitted in connection with this application, including any personal and professional financial statements attached to or provided pursuant to this application, is true and accurate as of the date of submittal, and I agree to notify Franchisor of any material change in my personal, professional or financial status while this application is pending.