Accrue Factoring, Inc. Transportation Solutions Application

Complete this application to request funding, fuel, equipment, insurance, compliance, and business growth solutions through Accrue Factoring, Inc.'s nationwide network of service providers.

This field is for validation purposes and should be left unchanged.

Section 1: Company Information

Legal Business Name:

DBA (if applicable):

Business Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Website:

Year Business Started:

Business Structure:

Industry:

MC Number (if applicable):

DBA Name (If Applicable):

Section 2: Contact Information

Name:

First Last

Title / Position:

Email Address:

Phone Number:

Best Time to Contact:

Section 3: Financing Request

Type of Financing Needed:

Funding Amount Requested:

Average Monthly Invoice Volume:

Average Invoice Size:

Number of Active Customers:

Customer Payment Terms:

Section 4- Customer/ Buyer Information

Primary Customer Name:

Region For Your Buyers

Customer Type:

Customer Industry:

Estimated Monthly Sales to This Customer:

Section 5- Trade Transaction Details:

Description of Goods or Services:

Do you have confirmed purchase orders?

Are goods already delivered?

Do you currently work with a factoring company?

Current Factoring Company:

Section 6- International Trade Section:

Export Country

Import Country

Estimated Shipment Value:

Shipment Method:

Section 7- Document Upload

File Upload:

1. Sample Invoice 2. Purchase Order 3. Accounts Receivable Aging Report 4. Contract or Sales Agreement 5. Financial Statements (optional)

Drop files here or

Max. file size: 300 MB.

Section 8- Authorization

I certify the information provided is accurate and authorize Accrue Factoring, Inc. to share this information with financing partners for funding evaluation.

Factoring Application