Commercial Invoice Factoring Application

The preliminary worksheet below is designed to provide Metropolitan Capital Now with an overview of your financial profile to determine the most suitable financing program for your business.

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Table of Contents

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SECTION 1: Business Information

Business Legal Name *

DBA (If Applicable)

Business Address *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Business Phone *

Business Email *

Website / URL *

Entity Type *--- Select Choice ---CorporationLLCPartnershipSole Proprietor

Years in Business *-choose-Less than 1 year1–2 years3–5 years5+ years

Federal Tax ID (EIN *

SECTION 2: Contact Information

Primary Contact Name *

Title / PositionOwnerBusiness OwnerFounderCo-OwnerPartnerManaging PartnerPrincipalCEO (Chief Executive Officer)PresidentOwner / CEOFounder & CEOManaging DirectorOther

Other Title / Position *

Do you have the authority to apply for or request financing on behalf of the company? *

• Yes

Phone

Email *

SECTION 3: Business Overview

Industry *-choose-Transportation / LogisticsManufacturing & WholesaleStaffingCommercial Building TradesManufacturingOther (with text field)

Other Industry *

Position Other have

Brief Description of Your Business *

SECTION 4: Accounts Receivable / Factoring Details

Average Monthly Revenue *--- Select Choice ---Under $100,000$100,000 – $250,000$250,000 – $500,000$500,000 – $1,000,000$1,000,000+

Average Monthly Invoices Submitted for Factoring *--- Select Choice ---First ChoiceSecond ChoiceThird ChoiceUnder $50,000$50,000 – $250,000$250,000 – $1,000,000$1,000,000+

Average Invoice Size *

Typical Payment Terms *--- Select Choice ---Net 15Net 30Net 45Net 60Net 90

Do your customers pay on time? *

• Yes
• Sometimes
• Often Late

SECTION 5: Customer Information

Number of Active (B2B) Customers *-choose-1–56–1011–2525+

Do you invoice other businesses (B2B)? *

• Yes
• No

Top 3 Customers (Names) *

SECTION 6: Current Financing

Do you currently factor invoices? *

• Yes
• No

Do you have any existing business loans or advances? *

• No
• Yes

Lender Name *

Current Balance *

Amount of Funding Requested *--- Select Choice ---Open/TBD/The maximum I qualify for.$250,000 – $500,000$500,000 – $1,000,000$1,000,000 – $5,000,000$5,000,000 – $25,000,000Other/Specific Amount

Specific dollar amount of funding *

How soon do you need funding? *--- Select Choice ---ImmediatelyWithin 1–2 weeksWithin 30 days

SECTION 9: Agreement & Submission

I certify that the information provided is accurate and complete *

• Confirmed

I agree to be contacted regarding financing options. *

• Confirmed

I authorize Metropolitan Capital Now and its partners to verify the information provided, including obtaining business and consumer credit reports as permitted by law, and to contact me via phone, email, or text regarding financing options. *

• Confirmed

I acknowledge that by clicking the “Submit” button below, a PDF application will open on my screen, and I agree to complete it in its entirety. I certify that all information provided is true and accurate. *

• Confirmed

Submit