QUESTIONS: 1 888-984-4701 / 1stTruckingFactoring.com / TruckingSupport.com

WHY FACTOR ANYWHERE ELSE? WE OFFER YOU:

STABILITY!

FACTOR WITH A LEADER THAT HAS BEEN IN BUSINESS SINCE

1807!

		NEED QUICK CASH?  QUICK FUNDING BY THE DECISION MAKERS!
		LOW TRUCKING FACTORING FEES! - HIGH ADVANCES ON ACCOUNTS RECEIVABLES!

FOR ADDITIONAL INFORMATION, Please complete the Short-Form below and submit. The Representative that handles your region will contact you shortly.

GENERAL INFORMATION
Legal Name of Business
City and State
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

Type of Business (Industry)	Please Make Selection Business to Business Distribution Freight Brokerage Manufacturer Medical / Healthcare Printing Telecommunications Transportation Trucking Service Staffing Wholesale Distribution Other
If Other, Explain
Type of Products/Services Offered
Name of CEO / Owner
How Long In Business

ABOUT ACCOUNTS RECEIVABLES
Dollar Amount of Receivables Now Open
Total Sales Last 12 Months
Approximate Number of Customers
Do You Sell on Terms of Net: 10 days 30 days	60 days 90 days
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

EQUIPMENT & INVENTORY SUB-LINES OF CREDIT & REAL ESTATE LOANS As an Asset Based Lending company, we can also offer our factoring customers:   Sub-Lines of Credit on their Trucks/Equipment and Inventory.  Commercial Real Estate Loans to purchase, refinance or improve  their commercial real estate properties. If interested, please indicate below: (Check all that apply) Equipment Sub-Line of Credit $  Value: Inventory Sub-Line of Credit $  Value: Real Estate (Commercial) $  Value: Other $  Value: If Other, Explain Our Sub-Lines of credit are only available in concert with a Factoring Facility. We do not offer stand-alone equipment/inventory loans. If you are interested in just an equipment loan, please visit EquipmentLending.com.

HOW DID YOU HEAR ABOUT US?   ------------------------>

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Our Trucking and Transportation Factoring Division thanks you for submitting the online form. The person that handles your region will contact you shortly. We hope to be your source for all your factoring needs. Again, thank you.