Application Statement

Part 5 of 5

Signature of the Applicant
Date
Signed on Behalf of (Name of Entity)
It is understood that the purpose of this application is for information only and is in no way binding upon either Nathan’s Famous, Inc., its affiliates, or the applicant. The information I have submitted within this application is true and complete to the best of my knowledge and belief.
I agree that the electronic signature is the legal equivalent of my manual signature on this application.