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Accrue Factoring, Inc – Client Referral Form

Contact Information

Name(Required)

First Last

Company Name(Required)

Company Website

Email Address(Required)

Phone Number(Required)

Country Phone Number

Business Information

Business Type(Required)

Years in Business(Required)

Annual Revenue(Required)

DOT or MC Number

Dot or MC number is only needed if factoring freight transportation receivables in the United States of America.

Financing Request

What type of financing are you interested in?(Required)

Funding Timeline(Required)

Trade Finance Information

Please provide information about your trade transaction so we can better understand your financing needs and determine the appropriate referral options.

Trade Finance Solution Needed(Required)

Transaction Type(Required)

Country of Origin(Required)

Where are the goods or products being shipped from?

Destination Country(Required)

Where are the goods or products being shipped to?

Products / Goods Being Financed(Required)

Briefly describe the products or goods involved in the transaction.

Estimated Transaction Value(Required)

What is the approximate total value of the transaction?

Funding Amount Requested(Required)

Approximately how much financing are you seeking?

Payment Terms(Required)

Do you currently have a Purchase Order?(Required)

Yes

No

Pending

Do you currently have an Invoice?(Required)

Yes

No

Not Yet

Is a Letter of Credit involved?(Required)

Yes

No

Not Applicable

Not Sure

Additional Transaction Details

Please provide any additional information about your transaction, financing needs, funding timeline, or other relevant details.

General Inquiry

Preferred Contact Method(Required)

Phone

Email

Either

How Can We Help?

Please tell us about your financing needs or how we can assist you.

Disclosure & Consent

Important Disclosure(Required)

I understand that Accrue Factoring, Inc. is a commercial finance referral and brokerage service and does not directly fund, approve, or guarantee financing. Submission of this form does not guarantee approval or funding.

Privacy & Contact Consent(Required)

I consent to Accrue Factoring, Inc. contacting me regarding my inquiry and understand that my information may be shared with an appropriate third-party funding source for the purpose of evaluating potential financing options.

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CONTACT US!

Accrue Factoring, Inc
77 Kosciuszko Street, #1360
Brooklyn, New York 11205

Phone Number: (646) 813-0183
Fax Number: (646) 813-0182
Email: support@accruefactoring.com
Website: www.accruefactoring.com

Get In Touch

Disclaimer:

Accrue Factoring, Inc. is a trade finance brokerage and referral service, not a direct lender. Financing is subject to independent provider approval, terms, conditions, and eligibility requirements.

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