Form I - Franchise Broker Registration Page 3

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Instructions for Preparing Form I - Franchise Broker Registration Form
1. Insert the name of the Franchise Broker and any name under which the Franchise
Broker is doing or intends to do business.
2. Insert the Franchise Broker’s principal address and telephone number.
3. Answer “Yes” or “No” to each question (A, B and C). If the answer is “Yes” to any
question, provide the requested additional information. For purposes of 3(B)., “hold
liable” means that, as a result of claims or counterclaims, the person must pay money or
other consideration, must reduce an indebtedness by the amount of an award cannot
enforce its rights, or must take action adverse to its interest. Accordingly, dismissals
concluding an adversary proceeding need not disclosed, but a settlement resolving an
adversary proceeding must be disclosed if the person is held liable as defined above.
4. Include a copy of the Consent to Service of Process, designating New York’s
Secretary of State as agent to receive process.
5. Complete and sign the jurat
6. If a Franchise Broker is no longer soliciting or offering or selling franchises on behalf
of the Franchisor, promptly notify the Department of Law by letter of the termination of
that relationship.

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