Commercial Finance & Factoring Programs: Applied Capital

Applied Capital, Inc.
3700 Rio Grande Blvd. NW
Suite 4
Albuquerque, NM 87107
T: 505.342.1840
F: 505.342.2246
info@appliedcapital.net

Application - Part 1
Fill in as much as possible. The more complete each answer, the sooner we can provide financing to you.

Type of Financing

Company Name

Contact Name

Company Address:

City:

State:

Zip :

Phone:

Fax:

e-mail:
required *

Who are your customers?

Note: Applied Capital only funds transactions in which your customers are businesses.

What is the amount of your financing request?

Company Description

Customer Description
Check all that apply

Large Fortune 500 Companies
Mid Size Companies
Small Businesses
Government Agencies
Schools
Municipalities

Are your Accounts Receivable pledged as collateral on any outstanding loans?

What is your Average Monthly Sales Volume?

What is your average invoice size?

Enter the approximate amount of your accounts receivable.

What percentage of your accounts receivable total is less than 90 days old?

What is the average collection time of your invoices?
0 to 15 days
16 to 30 days
31 to 45 days
46 to 60 days
61 to 90 days
Over 90 days

Does the company have an Federal Tax Liens filed against it?

Comments on your request for financing.

How did you hear about Applied Capital?