FROM: RALPH KEYSLAY TEL: 603-888-8881 FAX: 603-888-6081

Confidential Candidate Evaluation

THIS IS NOT A CONTRACT

This is not a contract and does not obligate either party in any manner. All information will be
held in complete confidence.

Client Information
Date:09/08/2009 Name:Carl Kaufman
Home Number:732-727-7941 Work Number:732-921-0003
Cell Number:732-921-0003
E-Mail:carlikaufman
Address:31 Cori Street
City, State, Zip Code:Parlin, NJ 08859

Personal Information
Date of Birth:01/18/1955 Marital Status:Married

Spouse's Name:Regina Spouse's Occupation:Sales

General Health:Good Total Dependants:3

Are you a U.S. Citizen? If not, what country?

Yes
Home: Own or Rent/How long?
Own/5 Years
Former Residence:
32 Eulner Street Sayreville, NJ
What Source Prompted your Inquiry?
Interested in franchises
Who referred you to us?
I got an e-mail
Professional Experience
1. Company:Fed-Ex Address:135 Essex Street Avenel, NJ
Division:Home Delivery Employed from:10/2005 to:09/2009
Describe responsibilities:
Deliver packages to homes and businesses

2. Company:Station Cab
Division: Employed from:08/95 to:09/2005
Describe responsibilities:
Picked up and dropped off
passengers at different places

3. Company:Star Ledger Address:Newark, NJ

Division:home delivery Employed from:10/1989 to:07/95

Describe responsibilities:
Assisstant Management

Education
Last year of High School completed: 4
(1, 2, 3 or 4)
Last year of College completed:
(1, 2, 3, 4 or 5)
Last year of Post-Graduate completed:
(1, 2, 3 or 4)
School/University Name: Year Graduated:

Degree: Special Certification:

General
Would you plan to spend full time in this business? Yes
If not, please explain your other obligations:

Have you ever failed in business or compromised NO

with creditors?
If yes, please explain:
Personal Financial Statement
Please answer all questions, using "no" or "none" where necessary.

Assets Current
Cash on Hand and Unrestricted in Banks…………………............ $50,000.00
U.S. Government Securities………………………………............. None
Notes Receivable………………………………………………….. None
Life Insurance, Cash Surrender Value - NOT death benefit……. None
amount (do not deduct loans)
Other Stocks and Bonds……………………………………........... none
Real Estate……………………………………………………........ $375,000.00
Automobiles Registered in Own Name…………………………... $10,000.00
Other Assets (itemize) none

Total Assets……………………………………………. $435,000.00

Liabilities & Net Worth Current

Notes Payable to Banks…………………………………………… $5,000.00
Notes Payable to Others…………………....................................... none
Loans Against Life Insurance……………...................................... none
Accounts Payable………………………………………………… None
Interest Payable………………………............................................ none
Taxes and Assessments Payable………………………………..… $10,000.00
Mortgages Payable on Real Estate………………………………... $450,000.00
Brokers Margin Accounts……………............................................ none
Other Liabilities (itemize)credit cards $151,000.00

Total Liabilities…….…………………………….......... $480,000.00

Total Assets - Total Liabilities = Net Worth………..... $-45,000.00

Source of Income Current

Salary (annualized)………………………………………………. $112,000.00
Bonus and Commissions………………………………………….. None
Dividends and Interest……………………………………………. None
Real Estate Income………………………………………………... None
Other Liabilities (itemize) none

Total Income…………………………………………… $112,000.00

Total Amount to Invest $50,000.00

Location Preferences
First choice: CitySayreville StateNJ
Second Choice: Citywoodbridge StateNJ
Third Choice: CityOld Bridge StateNJ
Would you be willing to relocate?

References

Business References
1. Company Fed-ex Phone732-636-8204
Contact Andrew Whitman Address135 Essex Ave Avenel, NJ
2. Company Station Cab Phone732-388-2222
ContactTommy AddressRahway, NJ

Personal References
1. Name Peter Harbianco Phone732-5221646
AddressRahway, NJ

2. Name Seymour Kaaufman Phone609-655-3853

Address138B Cistus plaza

Bank References
Bank NameRaritan Bay Federal Credit Union
Contact Phone732-727-3500
Place an ‘X’ next to the traits below that apply to you:

_X_ Likes positions of authority _X_ Enthusiastic

_X_ Takes charge _X_ Adventurous
_X_ Determined __ Motivator
_X_ Confident _X_ Energetic
_X_ Firm __ Very verbal
__ Enterprising __ Promoter
X Competitive _X_ Friendly, mixes easily
_X_ Enjoys challenge _X_ Enjoys popularity
__ Problem solver _X_ Fun loving
__ Productive _X_ Likes variety
__ Bold __ Spontaneous
__ Decision maker __ Enjoys change
X__ Strong willed _X_ Creative - new ideas
_X_ Independent, self-reliant __ Group oriented
__ Controlling __ Optimistic
_X_ Persistent __ Initiator
_X_ Action oriented _X_ Infectious laughter
_X_ "Let's do it now" __ Inspirational
_X_ Hard charging _X_ "Trust me! It'll work out"
_X_ Not afraid to take risks _X_ Outgoing
_X_ Efficient _X_ Empathetic
_X_ Disciplined _X_ People oriented
_X_ Results oriented __ Charming
__ Gut based decisions _X_ Affable
_X__ Achieving results __ Talkative
_X_ Accepting personal challenges _X_ Trusting
_X_ Create efficiency __ Highly influential
_X_ Speak pointedly _X_ Gut based
_X_ Direct __ Building quality relationships
_X_ Tell it like it is _X_ Having fun
_X_ Strong opinions __ Attaining social recognition
__ Listen to headlines __ Trouble saying “no”
__ Give me the highlights __ Tendency to over promise
_X_ What’s the bottom line __ Trouble managing time effectively
_X_ Strong personality __ Problem solver
__ Strategic _X_ Visionary – see the big picture
_X_ Tactical _X_ Avoid conflict
__ Visionary _X_ Goal oriented
_X_ Self directed __ Influence others
_X_ Responsible _X_ Work well with others
__ Self managed __ Great communicator
__ Natural born leader _X_ Function well on a team
__ Get involved _X_ Positive energy
_X_ Strong operational focus _X_ Good customer service skills
__ Multi-tasker _X_ Solicits feedback
__ Create win-win solutions _X_ Entrepreneur
__ Strong decision maker __ Risk taker
_X_ Common sense approach to business __ Quick to make decisions
_X_ Put forth a heroic effort and play to win __ Like change
__ Moves fast
__ Quick to implement decisions
_X_ Create trust in others
_X_ Confident
__ Limited patience
_X_ Enjoys instructions _X_ Sensitive feelings
_X_ Accurate _X_ Loyal
_X_ Consistent _X_ Calm, even keel
_X_ Controlled __ Non demanding
_X_ Reserved _X_ Avoids confrontation
__ Predictable __ Enjoys routine
_X_ Practical _X_ Humble
_X_ Orderly __ Gives in
_X_ Factual __ Indecisive
_X_ Conscientious _X_ Will do without
_X_ Perfectionist _X_ Adaptable
__ Discerning _X_ Sympathetic
_X_ Inquisitive _X_ Thoughtful
_X_ Precise _X_ Nurturing
__ Scheduled _X_ Tolerant
__ Dry Humor _X_ Peace Maker
_X_ "How was it done in the past?" __ "Let's keep things the way they are"
_X_ Exact _X_ Dependable
_X_ Focused _X_ Good natured
_X_ Detailed __ Systems oriented
__ Neat _X_ Open minded
__ Systematic __ Consistent
_X_ Polite _X_ Persistent
_X_ Logical _X_ Level headed
_X_ Professional __ Pragmatic
_X_ Slow paced _X_ Sincere
_X_ Analytical _X_ Empathetic
_X_ Compliant _X_ Team player
_X_ Methodical _X_ People oriented
_X_ Driven by perfection __ Introverted
_X_ Need clear instructions on what’s expected __ Less emotional
_X_ “Tell me how you want it done and I’ll do it” __ Needs security
__ Task oriented _X_ Wants stability
_X_ Self directed __ Strive to belong
__ Prefer to work alone __ Resistant to change
_X_ Like to be informed _X_ Make slow and informed decisions
_X_ Analyze lots of data prior to making a decision _X_ “Play not to lose”
__ Introverted __ Seek to eliminate risk
__ Aloof _X_ Highly detailed
__ Critical __ Very organized
__ Risk-averse __ Slow placed
__ Resistant to change _X_ Patient
_X_ Objective and open minded to new information _X_ Objective
__ Process driven __ Great listener
_X_ Quality driven _X_ Easy to get along with and talk to
_X_ Function well within a structured environment __ Prefer a predictable, structured environment
__ Great listening skills __ Timid
_X_ Very good at remembering details __ Possessive
__ Uncanny ability to spot what is missing or broken __ Methodical
__ Diplomatic _X_ Process driven
_X_ Excellent with numbers _X_ Good memory
_X_ Persistent __ Team builder
_X_ Work at a steady pace _X_ Strong customer skills
_X_ People can count on you _X_ Know how to build quality relationships
_X_ Like to gather lots of information _X_ Highly analytical
_X_ Make data-based decisions __ Good communicator
_X_ Can follow someone else’s proven process
Applicant: Please Read & Sign

It is understood that the purpose of this questionnaire is for information only and is in no way
binding upon the franchise company, its agents, representatives or the applicant. It is, however,
understood that the applicant supplies this information contained herein to the best of his
knowledge and ability and that the franchise company, its agents, representatives, rely on this
fact in assessing the desirability and qualifications of the applicant. This application will serve
as authorization for franchise company, its agents, or representatives to complete credit and other
background checks.

Submitted this:8th day of:September , 2009

NameCarl Kaufman
Signature