Possible Factoring Arrangement

If you are interested in pursuing our services, please provide the following information for your operation on the form below, and either fax it to us at (253) 875-7222 or e-mail to traci.nfi@comcast.net

If you have any questions, please call 1-866-770-7200 and ask for Traci.

Contact Name:
Email Address:
Company Name:
Business Address:
City:
State:
Zip:
County:
Business Phone:
Fax:
Cell Phone:
Legal Status: Corporation Sole proprietor
Partnership LLC LLP Other
If LLC or corporation, state of formation:


If Partnership state of principal office:
Number of trucks:
Anticipated monthly Dollar Volume to Factor:
   
Federal Tax ID Number:
MC Number:
Are you factoring now: Yes    No
Current creditors who have UCC filings on your organization:
Are there any existing liens filed against the organization:
List of existing and/or anticipated customers you would factor:
Referred by:


Officers, Directors, Sole Proprieters and/or Principal Owners

Name:
Title:
Home Address:
City:
State:
Zip:
Home Phone:
Social Security Number:
Date of Birth:


Second Officer/Director/Owner Information

Name:
Title:
Home Address:
City:
State:
Zip:
Home Phone:
Social Security Number:
Date of Birth:

 

Third Officer/Director/Owner Information

Name:
Title:
Home Address:
City:
State:
Zip:
Home Phone:
Social Security Number:
Date of Birth:



Statement

The above statements are true and accurate to the best of my knowledge and belief. This serves as my permission for the release of any information to Neal Freeman Investments, LLC. regarding this application for the purpose of credit investigation. I hereby authorize Neal Freeman Investments, LLC to investigate the credit of all parties listed above.

Name and title of person filling out this application:

 
 
 

Neal Freeman Investments, LLC. 18407 Pacific Ave. S., #24, Spanaway, WA 98387
Phone: 253 875-7200 Fax: 253 875-7222 Email: traci.nfi@comcast.net