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COMPANY NAME *
COMPANY WEBSITE
STREET ADDRESS *
CITY *
STATE *
ZIP CODE *
PHONE *
FAX
EMAIL *
DECISION MAKER NAME *
DECISION MAKER TITLE *
ADDITIONAL CONTACT NAME
ADDITIONAL CONTACT TITLE
PPRODUCTS/SERVICES? (Manufacturers of all types, Business services, Distributors, Labor intensive companies) *
LARGEST $ VOLUME CUSTOMERS? (Governments, Institutions, Creditworthy commercial companies) *
YEARS IN BUSINESS? *
AVERAGE INVOICE AMOUNT? *
INVOICE TERMS? (Net 30 days is standard) *
REALISTIC PAYMENT? (Average number of days it takes customer to pay invoices)
AVERAGE MONTHLY SALES? *
AMOUNT OF CASH NEED? (The largest factoring amount that will be outstanding at any point in time) *
WHY IS CASH NEEDED? (payroll, taxes, supplies...) *
WHEN IS CASH NEEDED? (Realistic time frame for needing the cash) *
TAX LIENS? (We have experts at handling tax liens that must be resolved prior to funding) * Yes No
GOOD PERSONAL CREDIT? * Yes No
CURRENTLY FACTORING? * Yes No
BANK LINE? (If lender has Accounts Receivable as security for a loan: Provide lender's name and amount owned) * Yes No
UCC-1 FILINGS? (Any that have accounts receivable as collateral? If so, how many UCC-1 filings exist & in what state(s)?) * Yes No
ADDITIONAL INFORMATION/SPECIAL CONSIDERATIONS
 
 
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