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Compensation Form

The franchiser, _________________, and the franchisee, _______________, as set forth in their franchise agreement on _____________ and as witnessed by _________________________________, have agreed to the following additional terms and conditions:

Franchiser shall be compensated in the amount of __________________ by the franchisee in the following manner:

I, _______________, agree to pay _________, the following sum _______________ in _________(monthly, weekly, yearly increments) of _______________.

Payments will commence of _________________.

Date: ________.

____________________________

Franchiser

____________________________

Franchisee

____________________________

Witness

____________________________

Witness