HICKORY HOLLOW MALL

SPECIALTY LEASING PROSPECT INFORMATION
New ______________

Renewal ______________

Contact Name: _________________________________________________________
Tenant Name (Legal Entity): _______________________________________________
Lease Name (dba): ______________________________________________________
Address: ______________________________________________________________
City: ___________________________

State: _____

Phone: (______) ________________

Zip code: _______________

Alternate Phone: (______) ________________

Fax: (______) ________________ Email: ________________________________
Social Security Number or Tax ID Number: ___________________________________
Business Type: Individual

Corporation

State of incorporation: ________

Concept/Product Information:

1. What product(s) or service(s) will you provide? ___________________________________
2. List average price point. $__________________
3. Are you currently operating a business? Yes

No

a. If yes, please explain? _________________________________________________
b. If no, have you operated a business in the past? ____________________________
4. Have you ever operated a business in a mall? ___ Yes

___ No

If so, which

mall(s)? __________________________________________________________________

5. Do you have established resources/suppliers for the product you will sell? ______________

Are you interested in: Cart/RMU _____ In line _____ (Approx sq.com . TN 37013 Fax: 615-731-1034 | Email: Taffany_Britton@cblproperties. How long does it take to receive or produce your product? __________________________ 7. When would you like to open? _________________________________________________ 10._________________________________________________________________________ 6. Please provide any additional details not already covered. What sales volume do you project for your concept? $____________ per ______________ 8. ft needed ______) 9. ___________________________ _________________________________________________________________________ _________________________________________________________________________ Return completed form to: Mail or in person: Hickory Hollow Mall * Mall Office * 5252 Hickory Hollow Parkway * Antioch.