Factoring Pre Approval Application Form

Privacy Policy: The information provided by an authorized business representative will be used solely to determine which factoring program is best for your business and is true and correct to the best of my knowledge. It's Our goal to get you the Working Capital You deserve and improve Your Cash Flow.

Upon submitting your Factoring Pre Approval Application you are authorizing Diversified Financial Services to check credit information pertaining to all information in this Pre-Approval Application.

Your Name:

Legal Bus Name:

Business Address:

Phone Number:

Email:

Briefly describe your business:

How long have you been in business?

Approx profit margin (Sales less Direct costs)

Average monthly sales?

Average Invoice Amount?

Dollar volume do you want to factor monthly?

Provide us with two customers you would like to factor:

Customer #1

Address:

Approx monthly amount:

Approx days for pmt:

Customer #2

Address:

Approx monthly amount:

Approx days for pmt:

How did you hear about us ?

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Diversified Financial Services Toll Free: 800 954-0012 Fax: 866 219-5261