ACCOUNTS RECEIVABLE FACTORING
Client Profile (Please Complete the following for referrals and fax to 517-381-8758)
PK Mortgage & Financing Services, Inc. Phone No. 517-381-8757
Exact Legal Company Name DBA (if aplic)
Address Years in Business
City, State, Zip Phone
Contact Name Fax
Business Description Corp LLC Partnership Sole Prop. (Please Circle)
Receivable Information
Average size of invoices Number of Invoices (Monthly) Estimated Monthly Billing
Are Receivables Pledged as Security Elsewhere Yes No If so, to whom? Explain
Listing of Principal Accounts Receivable/Clients
Name of Clients City, State, Zip Telephone Average Monthly Billing
Subject to the terms and conditions of Agreement and due diligence