Application - Advanced Commercial Capital

Get Approved and Start Improving Your Cash Flow

If you are ready to improve your cash flow with Advanced Commercial Capital’s low-risk, non-recourse approach to freight bill factoring, simply complete the application below. There is no obligation, and you are not agreeing to anything. However, this information will allow us to begin the approval process and make things even quicker and easier when you are ready.

The fields marked with * are mandatory.

Factoring Application

step 1: Company Information

Business Name:*

Dba Name: (if different)

Physical Address

Physical Address:*

City:*

State:*

Zip:*

Mailing Address

Mailing or Business Address: (if different)

City:

State:

Zip:

Contact Information

Contact Name*

Phone*

Cell:

Fax:

Email:*

Website:

Detailed Company Information

County

Federal EIN

Number of Employees

Dun & Bradstreet No.

Legal Status/Structure*

Legal Status/Structure (if other)

Date Business Established*

State Business Established*

Description Of Business*

step 2: OWNERS, OFFICERS AND/OR PARTNERS

Officer 1

Name:*

Title*

% Owned:*

Driver’s License #/State*

Home Street Address:*

Home Status:*

City:*

State:*

Zip:*

Home Phone:

Social Security #:*

Date of Birth:*

Email*

Officer 2

Name:

Title

% Owned:

Driver’s License #/State

Home Street Address:

Home Status:

City:

State:

Zip:

Home Phone:

Social Security #:

Date of Birth:

step 3: BUSINESS BANKING INFORMATION

Name of Bank:*

Bank Officer:*

Address:*

City:*

State:*

Zip:*

Phone:*

Fax:

Checking Account #:*

ABA Routing #:*

Date Opened:*

step 4: TRADE REFERENCES

Trade Reference 1

Supplier Name:*

Address:*

City:*

State:*

Zip:*

Phone:*

Fax:

Account #:

Trade Reference 2

Supplier Name:

Address:

City:

State:

Zip:

Phone:

Fax:

Account #:

step 5: FINANCIAL INFORMATION

Bankruptcy

Has your company, or its owners, ever filed for bankruptcy, or are you currently operating under bankruptcy proceedings?*

If yes please explain below:

Taxes

Federal or State Taxes Past Due?*

If yes, Type/Amount

Tax Lien Filed?

History/Financial Practices

Has your company ever sold, factored, or pledged its receivables?*

If yes, with whom?

What are your average monthly sales?*

Anticipated monthly factoring volume:*

Current Outstanding Receivables:*

Average Invoice Amount:*

What are your standard invoice terms?*

Explain if other:

Do you have any commercial loans outstanding?*

If yes, provide lender name:

step 6: TRUCKING AUTHORITY

MC #:*

US DOT #:*

Authority Type:*

Do you have broker authority?*

If yes, what is your broker MC #?

If you have broker authority, do you intend to factor brokered loads?

Have you ever done business under any other name?*

If yes, provide the name and address where you operated below:

Have you ever operated under any other MC or US DOT numbers?*

If yes, provide the MC and/or US DOT number(s

step 7: MISCELLANEOUS INFORMATION

Has there been a change of ownership in the past two years?*

If yes, please explain below:

Does your company own or rent its business location?*

If you lease, please provide the following information:

Name of Landlord and/or Management Company:

Phone:

Period of Present Lease:

How Long at Current Location:

Monthly Payment:

How did you find out about Advanced Commercial Capital?

step 8:UPLOAD SUPPORTING DOCUMENTS

To expidte the approval process we recommend you upload the documents listed below. We accept PDF, DOC, DOCX, JPG, PNG and GIF.

> Copy of Owner’s Driver’s License
> Copy of Operating Authority with MC#
> A Completed W-9 Form
> Copy of a blank, voided check

Drag & drop files here

Open the file Browser

File List

No files uploaded.

step 9: AUTHORIZATION

I/we hereby certify that the information supplied in the Application and all forms and documents submitted to Advanced Commercial Capital herewith is true, correct and complete to the best of my/our knowledge and belief. I/we understand that the submission of this application indicates my/our intention to enter into a Security Agreement with Advanced Commercial Capital but does not obligate Advanced Commercial Capital to factor/finance or provide and financial services whatsoever. This serves as my authorization for the release of any information to Advanced Commercial Capital regarding this application for the purpose of credit investigation. I hereby authorize Advanced Commercial Capital to investigate the credit of all parties listed above. I also herein authorize Advanced Commercial Capital to contact our customers to verify any invoices submitted for factoring. I/we also authorize any financial institutions, trade references, and other vendors to release necessary information to Advanced Commercial Capital in order to verify the information contained herein.

Name:*

Title:*

Application Submitted!

Thank you,

Your information has been sent.
We will respond to your request as timely as possible and get back with you as needed.

Thanks again,
The staff at Advanced Commercial Capital

Freight Factoring Application

step 1: Company Information

Physical Address

Mailing Address

Contact Information

Detailed Company Information

step 2: OWNERS, OFFICERS AND/OR PARTNERS

Officer 1

Officer 2

step 3: BUSINESS BANKING INFORMATION

step 4: TRADE REFERENCES

Trade Reference 1

Trade Reference 2

step 5: FINANCIAL INFORMATION

Bankruptcy

Taxes

History/Financial Practices

step 6: TRUCKING AUTHORITY

step 7: MISCELLANEOUS INFORMATION

step 8:UPLOAD SUPPORTING DOCUMENTS

Drag & drop files here

step 9: AUTHORIZATION

Application Submitted!

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