Factoring Application for Invoice Factoring - United Capital Funding Corp - Factor Business Invoice Financing Cash Flow Loans Tampa Fl

Factoring Application
Apply Online For the most expedient response to your interest in factoring services, complete the online application (all fields of information) and submit the Secure Online form on this website page.

Or alternatively, you may complete and submit our quick financing application to begin the process of factoring your Accounts Receivables.
Factoring Application (pdf version, click to view, print and complete)
Factoring Application (Microsoft Word Digital Version: Save to your computer and complete)

Toll Free Phone
877.894.UCFC (8232)

BUSINESS INFORMATION Company Name   DBA

Current Address Street

City

State Zip Code

Telephone Number    Fax Number

Email Address

Website URL

Federal Tax ID Number State of Formation

Is the Business

Type of Business

PERSONAL INFORMATION Name % Ownership

Home Address Street City

State Zip Code

Phone Cell Phone

Fax

Email Address SSN

LIST OTHER OWNERS / PARTNERS (if more than 2 owners / partners, provide additional documentation separately via fax or email)
Name % Ownership

Home Address Street City

State Zip

Phone Fax

Email Address SSN

DOLLAR AMOUNTS OF COMMERCIAL A/R NOW OPEN Also, please email (to peggy@ucfunding.com) or fax (727-898-4205) a current A/R aging with your application if available. If you are a start up business, please simply put $ 0 in the table below:
Total Outstanding $ Current $

30 Days Old $ 60 Days Old $

90 Days Old $

ADDITIONAL INFORMATION Are any Accounts Receivables pledge as collateral?

If Yes, to Whom?

Are you currently factoring?

If Yes, to Whom

Do you process your own payroll?

Have you ever filed for bankruptcy?

Are there any judgments pending by or against the company?

Is there any pending or threatened litigation against the company?

NAME OF 4 LARGEST ACCOUNTS TO BE FACTORED Customer #1 Name

Street Address

City State

Zip Code
Average Monthly Sales for this Customer

Average Time it takes to get paid (in days)

Credit Line Desire for this customer

Customer #2 Name

Street Address

City State

Zip Code
Average Monthly Sales for this Customer

Average Time it takes to get paid (in days)

Credit Line Desire for this customer

Customer #3 Name

Street Address

City State

Zip Code
Average Monthly Sales for this Customer

Average Time it takes to get paid (in days)

Credit Line Desire for this customer

Customer #4 Name

Street Address

City State

Zip Code
Average Monthly Sales for this Customer

Average Time it takes to get paid (in days)

Credit Line Desire for this customer

Where did you hear about United Capital Funding?

Please click the Submit Key below to provide for quick processing of your application. By submitting this application, you authorize United Capital Funding Corp to use any credit bureau or business to verify any information that is provided.