Section 200.APPENDIX F Certificate of Deposit Forms

Section 200.ILLUSTRATION B Franchisee's Petition for Release of Certificate of Deposit

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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 the release of the Certificate of Deposit issued in the name of the Administrator in the sum of ___________, plus accrued interest representing the franchisee 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 has commenced doing business.

In furtherance of this request, the undersigned franchisor submits the franchisee's statement indicating that it has no objection to this request.


				Signature
				Printed Name of Franchise
				Address of Franchisee
Subscribe and sworn to before me
this		day of	,
	.

Notary Public

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