Qualifying Questionnaire
--- Factoring ---
Company Name:
Enter Company Name
MC#
MC
DOT#
DOT
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Address
City:
ST:
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Zip:
Contact
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Email:
Please Enter Company Contacts Email
Founded
Phone
Ext
Cell
Phone2
Equipment Types?
List Owners & % of ownership
Number of Trucks?
Number of trucks please
Number of Trailers?
Number of trailers please
Has your company or any current owner ever filed bankruptcy?
YES
NO
If yes, when??
Do you currently use a factoring company?
NO
YES
What is your current rate?
When does your contract expire?
Does the provider hold an escrow?
YES
NO
What percent do they hold?
Are your receivables pledged as collateral?
YES
NO
Total outstanding receivable amount:
How many customers do you have with terms greater than Net 30?
How often do you need funding?
Choose
Daily
Weekly
Bi-Weekly
Which payment method do you prefer?
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Check
ACH
Pickup
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