FACTORING SHORT FORM QUESTIONS? 1-888-984-4701 We offer one of the lowest factoring fees in the industry. For a price quote, please complete the Short-Form below. GENERAL INFORMATION Legal Name of Business City State AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Select Contact Name Your Position With The Company Attorney CEO CFO Controller COO CPA Director Executive VP Office Manager Owner President Sr. Vice President Vice President Assistant Vice President Other Select Email Phone Fax . COMPANY INFORMATION . Type of Business Select Your Industry Business to Business Distribution Fashion-Apparel Freight Broker Manufacturer Medical / Healthcare Printing Security / PI Firms Service Staffing Telecommunications Transportation Trucking Wholesale Distribution Other If Other, Explain Type of Products/Services Offered Name of CEO How Long In Business Number of Employees Type of Ownership Corporation S Corporation Sole Proprietorship Partnership Limited Liability Company State of Incorporation (if applicable) Is Your Company Public or Private? Public Private . . ABOUT ACCOUNTS RECEIVABLES . Dollar Amount of Receivables Now Open Average Monthly Sales Total Sales Last 12 Months Total Returns last 12 months (if none put "none") Percentage of Bad Debts last 12 Months Approximate Number of Customers Do You Sell on Terms of Net: 10 days 30 days 60 days 90 days Do You Offer Early Payment Discounts: NoYes (If yes, what percentage?% Average Invoice Amount Are Your Accounts Receivables Pledged as Collateral? No Yes If YES, to whom? ANTICIPATED MONTHLY FACTORING VOLUME Amount You Intend To Factor on Monthly Basis Maximum Anticipated Annual Factoring Volume Are You Factoring Now or Factored in the past? Yes No If Factoring Now If Factored in the Past . HOW DID YOU HEAR ABOUT US? ------------------------> Please Select One Attorney Bank Other Lender Broker CPA CFG Client Alta Vista AOL Ask Jeeves Excite Google HotBot Jayde Lycos MSN Overture Yahoo YellowPages Other Thank you for submitting the online form. The person that handles your region will contact you shortly. By submitting this online form, you understand that you are providing this information for the sole purpose of assisting our Corporate Factoring Group Division or assigns with its initial evaluation of your request and does not represent or imply a commitment or obligation to provide factoring or financing. All requests are subject to final approval. Again, thank you.
FACTORING SHORT FORM QUESTIONS? 1-888-984-4701
We offer one of the lowest factoring fees in the industry. For a price quote, please complete the Short-Form below.
COMPANY INFORMATION
Are You Factoring Now or Factored in the past?
If Factoring Now
If Factored in the Past
Thank you for submitting the online form. The person that handles your region will contact you shortly. By submitting this online form, you understand that you are providing this information for the sole purpose of assisting our Corporate Factoring Group Division or assigns with its initial evaluation of your request and does not represent or imply a commitment or obligation to provide factoring or financing. All requests are subject to final approval. Again, thank you.