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Online Short Application

Applicant Information
*Business Name:
*Contact/Owner:
Title
*Address Street :
*City:
*Select State:
*Zip code:
(5 digits)

Business Information
Legal Status( Corp,LLC,Sole Prop, etc.) :
Number of years in business:
Describe Business/Products:
Business Website:
Has company ever filed for bankruptcy?
Yes No
Any Federal or State taxes past due?
Yes No
Are there any judgements pending by or against the company?
Yes No

Contact Information
*Daytime Phone:
Cell Phone:
*Email:
Used for our purposes only.
*Personal Credit Score

Financial Information
Type of Finance Seeking?
Accounts Receivable Financing
Purchase Order Financing
Merchant Cash Advance
Inventory Finance
Equipment Leasing
Unsecured Line of Credit
Finance Amount Requesting

For Accounts Receivable Factoring
Total Sales Last Fiscal Year
Current Monthly Sales Volume
Year-to-Date Sales Volume
Average Invoice Dollar Amount
Average number of invoices that you would plan to factor monthly
When do you bill for your work

For Merchant Cash Advance
Average Visa/Mastercard Monthly Sales:
Average Ticket Size:
Have you used a cash advance plan before?
Yes No

Note: * Required Info
 


Forms and Applications

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