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Free
Business Receivables Factoring Application Form |
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APPLY NOW! |
FRANK KOVICH
(630) 229-5740
Locator ID# 501582
E-MAIL: Quoteanote@gmail.com |
Please Circle One Below
Construction Invoices Medical Invoices All Other Type Invoices
Please print out and
fill
in the blanks below. All fields are required. Please provide exact, accurate
responses to each question and do not estimate anything. Instead, take the time
to gather the information directly from your cash flow note or other paperwork.
Remember, the offer we make you will be based directly on the information you
provide, and if during due diligence we discover the information you provided
was not completely accurate, we will have no choice but to modify or rescind
our offer. HELP US HELP YOU!
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CONTACT INFORMATION |
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The person
completing this form is (owner, etc) |
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First &
last name: |
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Contact’s email
address |
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Phone |
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Type of business |
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BUSINESS INFORMATION |
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Name of business |
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Current Accounts
Receivable balance |
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How much would
you like to fund? |
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How long has your company been in business? |
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OTHER COMMENTS |
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Any additional information you think we should know |
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