Allied Capital Direct - AR Factoring Finance Lending - DFW Lubbock Austin San Antonio Houston

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:			$

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:

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.

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.