3010 LBJ Freeway #140 Dallas, Texas 75234
Phone: (972) 241-3297 Fax: (972) 243-6285

   
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  Printable Applications
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 GENERAL COMPANY INFORMATION

Applicant's Name
(Company Name)

Tradestyle Name(s)
Company Address
Street City State Zip County
Telephone Fax 
Federal Tax ID #
Business Type State Of 
Date Established Website 
Has there been a change of owners in the past year? Yes No
If yes, please explain:
Has the company ever changed its name? Yes No
If yes, please explain:
Have the principals/owners ever owned any other companies? Yes No
If yes, what are the names of those companies?
Approximate number of employees:
Other office locations:
PRINCIPAL / OWNER INFORMATION
President/Principal Driver's License #
Title Percentage Ownership %
Home Address
Street City State Zip County

Home Telephone

Social Security #

Date of Birth
Email Address
Vice President/Partner Driver's License #
Title Percentage Ownership %
Home Address
Street City State Zip County

Home Telephone

Social Security #

Date of Birth
Email Address
Secretary/Partner Driver's License #
Title Percentage Ownership %
Home Address
Street City State Zip County

Home Telephone

Social Security #

Date of Birth
Email Address
COMPANY FINANCIAL INFORMATION
Check One Manufacturer
Wholesaler
Other
Brief description of business
Yearly Sales $ of which we will factor approximately $
Gross Profit Margin % Terms of sale
Average collection period of A/R days Average Invoice Amount

Total Receivables Outstanding     $
1-30
$
31-60
$
60+
$
Total Billings during last 30 days  $ During last 12 months $
Number of active customers            Does your company obtain purchase orders? Yes No
Most Active Accounts
(List Names, Addresses, and Phone Numbers)
Contra Accounts
(Customers you may also buy from)
Name of Bank Name of Bank Officer
City State
Unsecured lines of credit Secured Lines
Any previous record of factoring? Names of previous factors
Purpose of contemplating factoring
Are receivables or inventory pledged as collateral? Yes No
If yes, to which lender?
Contact Person
Name

Contact

Phone
Any pending litigation against the owner(s)/officer(s) or company? Yes No
Any judgments outstanding? Yes No
Any Federal or State tax liens? Yes No
Any owner(s)/officer(s) or company ever filed for bankruptcy protection? Yes No
Any suit(s) filed against the company? Yes No
Has any company with whom any officer, director, partner, or principal has been associated within the past five years sold, factored, or pledged its receivables? Yes No
If a yes answer to any of the above questions, please explain fully below:
How did you hear about Goodman Factors?
Name of someone (not in your household) who can always reach you:
Name Address City State Phone Number
The statements made herein and all information in all documents provided herewith are true and correct and the Applicant(s) understands that Goodman Factors. intends to rely thereon in determining whether to enter in a financing relationship. BY SUBMITTING THIS ONLINE APPLICATION: Applicant hereby authorizes its suppliers, customers, accountants, attorneys, employees and credit agencies to provide Goodman Factors. any information about the Applicant and or its Officer(s) and its affairs, finances and accounts as Goodman Factors. or its employees may request. A copy of this authorization may be accepted as if it were an original.
 

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The following is a list of items required in order for us to evaluate prospective clients.

These items may be faxed to (972) 243-6285 or emailed to info@goodmanfactors.com


1) COPY OF CERTIFICATE OF INCORPORATION, IF INCORPORATED, OR SEE (2).

2) ASSUMED NAME CERTIFICATE IF A PROPRIETORSHIP OR PARTNERSHIP (SOME STATES CALL THIS A FICTITIOUS NAME CERTIFICATE). THIS IS USUALLY FILED WITH THE COUNTY. IF YOU HAVE NEVER FILED FOR AN ASSUMED NAME, CONTACT THE OFFICE OF YOUR COUNTY.

3) COPY OF AN INVOICE WHICH INCLUDES NORMAL SELLING TERMS (NET 30, NET 10 EOM, ETC.).

4) IF A CORPORATION: LIST OF CORPORATE OFFICERS AND PERCENT OF STOCK OWNED BY EACH. BE SURE TO INDICATE THE SECRETARY OF THE CORPORATION.

5) CURRENT FINANCIAL STATEMENTS DATED AND SIGNED.

6) PARTIAL LIST OF CUSTOMERS (THOSE WHICH MAY OWE OVER $1,000), AND THE APPROXIMATE AMOUNT OF CREDIT REQUIRED BY EACH. PLEASE GIVE COMPLETE ADDRESSES AND PHONE NUMBERS.

7) "PROSPECTIVE CLIENT INFORMATION" SHEET COMPLETED (FORM ATTACHED).

8) IF A PARTNERSHIP: COPY OF PARTNERSHIP AGREEMENT.

9) COPIES OF ANY CONTRACTS THAT MIGHT RESULT IN FACTORED INVOICES.


If your method of operation is as a Motor Freight Carrier, Cartage Company please include the following
:

10) COPIES OF ALL OPERATING AUTHORITIES.

11) COPIES OF ALL INSURANCE BINDERS (CARGO AND PL/PD).

 

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Form Security Statement:
The data on this form is transmitted by 128bit SSL, the industry standard for secure online transactions and banking.

Data Privacy Statement:
The information on this form is used for the sole purpose of applying with Goodman Factors.

Any and all of the data sent via this form will never be sold or made available to any other party except as needed to apply for Factoring as above or contact you for information relating to this transaction.

Contact Information:
Goodman Factors
3010 LBJ Freeway #140 Dallas, Texas 75234
Phone: (972) 241-3297  Fax: (972) 243-6285


info@goodmanfactors.com