Qualifying Questionnaire
--- Factoring ---
Company Name:
Enter Company Name
MC#
MC
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ST:
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Zip:
Contact
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Email:
Please Enter Company Contacts Email
Founded
Phone
Ext
Cell
Phone2
Number of Trucks?
Number of trucks please
Number of Trailers?
Number of trailers please
Equipment Types?
List all Owners & percent of ownership
Has your company or any current owner ever filed bankruptcy?
Choose
YES
NO
If yes, when??
Do you currently use a factoring company?
Choose
YES
NO
When does your contract expire?
Does the provider hold an escrow?
Choose
YES
NO
What percent do they hold?
Are your receivables pledged as collateral?
Choose
YES
NO
Total outstanding receivable amount:
How many customers do you have
with terms greater than Net 30? Number only please.
How often do you need funding?
Choose
Daily
Weekly
Bi-Weekly
Which payment method do you prefer?
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Check
ACH
Pickup
Who referred you to us?
What is two plus three?
Dont Forget to answer
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Rainbow Logistics LLC || 1725-B Highway 77 || Southside, AL 35907
Phone: (256) 485-1302 || Email:
thestaff@rainbow-logistics.com