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3-Consumer Receivables Financing Application

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3-Consumer Receivables Financing Application Powered By Docstoc
					                    Consumer Receivables Financing Application

                      Please complete and submit this Application to receive
                 a free, no obligation Consumer Receivables Purchase Proposal.
                                      Fax to 888-547-7993


Originating Broker:                                           (Authorized Agent for Smart Finance Options, Inc.)

Your Name


Company Name


Street Address


City                             State              Zip


Phone #                          Fax #


Best time to call                Email Address


                                 Number of
Length of time in business
                                 locations


Description of product or service purchased by consumer




Length of time before product or service is fully delivered
(include any promised support and/or guarantees)


How is your product or service sold to
consumers?

□ Yellow Page ads □ Direct sales □ Internet □ Phone
□ TV Infomercials □ Seminars
What is the profile of your customer?




Do you currently offer a financing program?   □ Yes □ No
If yes, do you currently sell these receivables?   □ Yes □ No
Which lenders do you currently use?




Will we replace or work in conjunction with your current financing program?
□ Replace □ Work With

What is the current monthly volume of financed sales?


What is the principal balance of your current receivables portfolio?


How much of that portfolio is delinquent (90 days or more past due)?


Do you check credit prior to extending financing?    □ Yes □ No

Which credit reporting agency do you use?    □ Experian □ Trans Union □ Equifax □ None

Contract: Average amount financed?


Contract: Down payment amount?


Terms offered?   □ 6, □ 12, □ 24, □ 36, □ 48, or □ 60 months

Interest rate charged %?


What do you do with delinquent accounts or write offs?




Will you need retail installment contracts supplied?   □ Yes □ No

Are company financial statements prepared?         □ Yes □ No

How often are company financial statements prepared?
Have you or your company ever filed for bankruptcy?   □   Yes   □ No
If yes, please provide details




How is your personal credit?




Explain any problem areas with your personal credit




Are the principals of your company willing to personally guarantee receivable purchases?
   □ Yes □ No

Have you had any complaints filed against you with the Better Business Bureau or the Attorney
General?    □ Yes □ No

If yes, please explain.




Any Additional Comments or Information

				
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