I hereby certify that all information provided in this application is true and correct as of the date below. I authorize Konz International Inc. or its affiliates of agents to conduct any necessary background checks. I understand that any false information or consequential omission contained in this application would be cause for immediate terminations of any subsequent agreement reached between myself and Konz.

The undersigned agrees that this and any subsequent information received will be held in the strictest confidence and only used for the sole intention of evaluating the Konz… pizza in a cone opportunity for the purpose of negotiating a Licensee Partnership.

The submission of this application does not obligate me or Konz International Inc. any way or manner.