DISCLOSURE OF IMPORTANT INFORMATION ABOUT BUSINESS OPPORTUNITY
Required by the Federal Trade Commission, Rule 16 C.F.R. Part 437
Name of Seller:
Address:
Phone:
Salesperson:
Date:
__________________________ has completed this form, which provides important information about the business
opportunity it is offering you. The Federal Trade Commission, an agency of the federal government, requires that
__________________________ complete this form and give it to you. However, the Federal Trade Commission
has not seen this completed form or checked that the information is true. Make sure that this information is the
same as what the salesperson told you about this opportunity.
LEGAL ACTIONS: Has __________________________ or any of its key personnel been the subject of a civil
or criminal action, including any FTC Rule, involving misrepresentation, fraud, securities law violation, or unfair
or deceptive practices, including any FTC Rule, within the past 10 years?
YES If the answer is yes, _______________ must attach a list of all such legal actions to this form.
NO
CANCELLATION OR REFUND POLICY: Does _______________ offer a cancellation or refund policy?
YES If the answer is yes, _______________ must attach a statement describing this policy to this form.
NO
EARNINGS: Has __________________________ or its salesperson discussed how much money purchasers of
this business opportunity can earn or have earned? In other words, have they stated or implied that purchasers can
earn a specific level of sales, income, or profit?
YES If the answer is yes, ________________ must attach an Earnings Claims Statement to this form.
Read this statement carefully. You may wish to show this information to an advisor or accountant.
NO
REFERENCES: In the section below, __________________________ must provide you with contact
information for at least 10 people who have purchased a business opportunity from them. If fewer than 10 are
listed, this is the total list of all purchasers. You may wish to contact the people below to compare their
experiences with what __________________________ told you about the business opportunity.
Note: If you purchase a business opportunity from __________________________, your contact information can
be disclosed in the future to other potential buyers.
Name
State
Telephone Number
Name
State
Telephone Number
1. _____________________________________ 6. ____________________________________
2. _____________________________________ 7. ____________________________________
3. _____________________________________ 8. ____________________________________
4. _____________________________________ 9. ____________________________________
5. _____________________________________ 10. ____________________________________
_______________
Signature: ________________________________________
Date:
By signing above, you are acknowledging that you have received this form. This is not a purchase contract. To give
you enough time to research this opportunity, the Federal Trade Commission requires that after you receive this
form, __________________________ must wait at least seven calendar days before asking you to sign a purchase
contract or make any payments.
For more information about business opportunities in general: Visit the FTC’s website at
or call 1-877-FTC-HELP (877-382-4357). You can also contact your state’s Attorney General.