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Factoring Application

We will use this information to identify potential factors.The information you provide will be subject to verification prior to funding. All information provided by you will be kept strictly confidential and will be delivered in a secure manner to the factor. Submission of Application authorizes Capitalinks or its agent(s) to conduct necessary credit inquiries. Some factors may require additional forms.

Today's Date:

Company Information

 

Company Name:

 

Attention:

 

Title:

 

Street Address:

 

 

 

City:

 

Province / State:

 

Postal / Zip Code:

 

Phone Number:

 

Cell Phone Number:

 

Fax Number:

 

Email Address:

 

http://

 

Form of Business:

Sole Proprietorship
Partnership
Corporation

 

Years in Business:

 

Industry:

 

A/R Information - last listing

 

Number of Customers:

Invoices / month:

 

Average $ value/invoice:$ 

Total Receivables:$   

 

Amount Borrowed Against Receivables: $   

 

Lender:

 

Amount You Wish to Factor per Month:$ 

 

Receivables Ageing - last listing

 

Current:$ 30 days:$ 60 days:$ 90 days:$ 

 

 


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