Factoring My Invoices and Accounts Recievable Diversified CashFlow Funding - Factoring - Note Buying

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Factoring My Invoices and Accounts Receivable

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Thank for your interest in factoring your invoices through our company. You may complete this form online for more information or click on the "Download Forms" button to the left and download the factoring form and Email it to DCFF@411-Cashflow.com All information will be kept in the strictest of confidence.
*Bold fields are required:*

*Email:*
*Company Name*
*Legal Name*
*Federal Tax ID#*
*Contact Name*
*Company Address*
Mailing Address
*Phone*
*Fax Number*
Business Type
*Business Structure*
*State / Date Formed*
*Liens on Invoices?*
*Terms of Sale*
*Number of Customers*
*Number of Invoices*
*Average Invoices Amt*
*Last Year Sales*
*Projected Sales*
*Bonded*
*Payroll Taxes Current?*
*Federal / State Taxes*
*Intent to Levy?*
*Judgments / Liens / Lawsuits*
*Loans Yes or No*
*Factored Before?*
*Financing Needed*
Additional Comments
*List Current / Future Customers*
*Company Principals / Officers*	The foregoing statements and information given above is true and correct to the best of my / our knowledge and is given to Diversified CashFlow Funding to induce funding source(s) to consider entering into a factoring agreement with the above company. I / we grant the Funding Source(s) of Diversified Cashflow Funding to verify and investigate all of the above statements and to review my / our credit report(s). The information submitted does not exclude any information relevant to the financial condition of this company / principal owner.
*I am an authorized agent of this company.*

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