Factoring Funding Financing Services

1-888-810-7154  |  Email: info@acplp.com

 


General Information

Legal Name of Business:

Offer Code

Trade Name:

Federal ID#:

 

Office Address:

Physical Address

City

County

State

Zip


Mailing Address:

Street/P.O. Box

City

County

State

Zip
 

Phone Numbers:

  
Telephone #                    Fax #

 


Toll Free #

Date Established:

 

 

 

 

Day

Month

Year

 


Company Structure:

 Corporation
 Partnership
 Proprietorship
 Other (Explain)

 

 

Year

State

 

 

Has there been a change of owners in the past year?  No  Yes

 

If yes, explain:

Has the Company ever changed its name?  No  Yes

 

 

If yes, explain:

Brief description of the business or primary product:

 

Individual Information

ALL OFFICERS, DIRECTORS, PARTNERS, and PRINCIPALS, please complete the following information:


Full Name:

First,                      Middle,                    Last                   Senior/Jr. etc.


Home Address:

 


City


County


State


Zip

 

 

 

Home Phone:

Social Security#:

Date of Birth:

Percentage Ownership:

Title:

Email Address:

 

Owner/Principal #2
Full Name:

First,                      Middle,                    Last                   Senior/Jr. etc.
Home Address:

City

County

State

Zip

 

 

 

 

Home Phone:

Social Security#:

Date of Birth:

Percentage Ownership:

Title:

Email Address:


Initial funding of $ needed.

Funds will be used to:
 


Accounts Receivable Information

Describe in detail your billing process from invoice to collection:

Total receivables:

 

$
Current

$
1-30 P/D

$
31-60 P/D

$
61+ P/D

 

 

 

 


Annual Revenue

Average number of invoices per month:

 

$

Average invoice amount:

$

 

Historical Information

Has the company ever sold, factored or pledged its receivables?

 Yes No

 

If yes, please provide the following: balance owed $

 

Name and address of lender:

 

Are the company's receivables currently being sold, factored or pledged?

 Yes No

 

Has any officer, owner or director been associated with a company that has previously factored its receivables?

 Yes No

 

If yes, name and address of lender

 

Is this company now, or has it ever been, in bankruptcy?

 Yes No

 

Are any federal and/or state taxes past due?

 Yes No

 

If yes, balance owed $

 


Final Application Step

 

 

The information supplied in this Application for Factoring submitted to Allied Capital Partners, L.P. is true and correct to the best of my knowledge. By submitting this form, I/we hereby authorize Allied Capital Partners, L.P. to investigate my/our credit worthiness and financial responsibility. I/we grant Allied Capital Partners, L.P/ the right to procure any and all credit reports pertaining to any party to this Application for Factoring.

E-mail Address:

Title:

Date:

 

 

 

Allied can deliver the funds you need within 24 hours.
The quickest way to secure funding for your business is to complete a full application and then speak with a Banking Relationship Manager. For most companies Allied can go from application to first funding within 24 business hours.

Speak directly with Allied about your capital needs, enter the information below and a representative will contact you within 2 hours. Our business hours are M-F 8-5 CST.
First Name: 
Last Name: 
Phone: 
Email:  
State:   
Initial funding needed:

Funds will be used to: