About Us
Services
FAQ Page
Contact Us
561-638-6067
mweinberg@weinberg-associates.com
About Us
Services
FAQ Page
Contact Us
Factoring Application
Your Funding Solution
Fill Form Below To Get Started
Step 1 of 2
50%
Company Name
*
Your Name
*
Office Phone number
*
Fax Number
Email Address
City, State
Business Description
Type of Company
Manufactorer
Staffing Company
Wholesaler
Other
Number of Customers on Aging
Average Invoice Amount
Standard Invoice Terms
If customer concentration exists (e.g., 40% of AR is with one customer) please provide details
Do You Have Credit Insurance?
Yes
No
Most Recent Month-end AR Aging Balance
Number of Years In Business
Desired Amount of Credit Line?
If you are currently financed by a lender, please complete the following...
If you are not, please click on the Submit button below.
Lenders Name
Type of Credit Line
Revolver
Term
Line Amount
Anniversary Date
Has the Lender Sent You a Notice of Termination?
Yes
No
Questions or Comments?
Place any questions you have here
Email
This field is for validation purposes and should be left unchanged.
