March 10, 2010
Please fill-in all the fields.  Mark  N/A  wherever you find your situation is not applicable.  The more details / information you give here will enable us to determine your funding requirement and provide the possible solutions at a faster pace.
Company Name:*
Contact Name:*
Company Address:
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Fax
Cell No:
Convenient time to call
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Who are your main customers?
Note: Finance Centre 4 You Inc. only funds transactions in which your customers are businesses.
What is the amount of your financing request?
Your company description
Customer Description
Are your Accounts Receivable pledged as collateral to any outstanding loans?
Pledged to:
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?
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