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 www.ftc.gov/bizopps

or call 1-877-FTC-HELP (877-382-4357). You can also contact your state’s Attorney General.