QUICK QUOTE Quick Cash GREAT FACTORING RATES Short-Form Below YOUR CONTACT INFORMATION Company Name Type of Ownership Corporation S Corporation LLC Partnership Sole Proprietorship Other How Long in Business? City and State Your Name 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 Select Assisted Living Facility Doctos Office Healthcare Staffing Home Healthcare Hospital Medical Practice Nursing Home Rehab Clinic Other ABOUT YOUR ACCOUNTS RECEIVABLES Type of Receivables/Collateral Please Select Commercial Insurance Equipment Equipment and ARs HMO/PPO ARs Managed Care ARs Medicaid-Medicare ARs Private Insurance Real Estate Real Estate and ARs RE and Equipment RE, Equipment and ARs Other Dollar Amount of Receivables Now Open Amount You Intend To Factor Monthly? IF NOT FACTORING Amount Seeking To Borrow? Are Your Accounts Receivables Pledged as Collateral? No Yes If YES, to whom? Are You Factoring Now or Factored in the past? Yes No If Factoring Now - With Whom? If Factored in the Past - With Whom? PLEASE GIVE US A BRIEF SUMMARY OF YOUR FINANCING NEEDS: Deal Directly With Decision Makers!
QUICK QUOTE Quick Cash
GREAT FACTORING RATES
Short-Form Below
Are You Factoring Now or Factored in the past?
Yes No
If Factoring Now - With Whom?
If Factored in the Past - With Whom?
Deal Directly With Decision Makers!