Application for Factoring Services | Texas Factoring Company

Please complete our secure online application below or download a PDF of our application. You’ll need to have the following items ready to upload or fax to us with your completed application.

Copy of Articles of Incorporation, Partnership Certificate (if you are a partnership), or Assumed Name Certificate (if you are a proprietorship/DBA)
Copy of each owner’s, shareholder’s, and principal’s Drivers License
Accounts receivable aging or a list of all outstanding invoices
Master customer list with names, addresses, and telephone numbers
Copy of a sample invoice with backup documentation (UPS #, purchase order, shipping order, signed delivery sheet, etc.)
Copies of all operating authorities and all insurance binders (cargo & PL/PD) — applicable only if you are a motor freight carrier, cartage company, broker, etc.

"*" indicates required fields

Basic Company Information

Legal Name of Company*

Federal Tax ID #*

Major Business

Phone*

Fax

Email*

Company Physical Address*

Street Address City State ZIP Code

Is company mailing address the same as physical address?*

Yes

Company Mailing Address*

Street Address City State ZIP Code

Business Type*

Partnership

Proprietorship

Corporation

State of

(if Corporation)

Date Business Started*

Has there been any ownership change in the last 2 years?*

Yes

If so, please provide details*

Has the business name changed within the last 2 years?*

Yes

If so, please provide former name and any details*

Has the business type changed within the last 2 years?*

(e.g. from Proprietorship to Corporation)

Yes

If so, please provide details*

Banking Information

Name of Bank

Name of Bank Officer

Bank Officer Phone Number

Bank Address

Street Address City State ZIP Code

Do you have an accountant outside of your company?*

Yes

Accountant Name

Accountant Phone

Accountant Address

Street Address City State ZIP Code

Average Number of Invoices Per Month*

Average Dollar Amount of Sales Per Month*

Terms of Sale (Net 10, Net 30, etc.)

Are you currently factoring?*

Yes

What company are you currently factoring with?

Are your receivables pledged as collateral?*

Yes

To whom are they currently pledged?

Are your taxes current?*

Yes

If not, please explain

Ownership Information

Owner Name*

Owner Home Street Address*

Street Address City State ZIP Code

Owner Driver’s License Number & State*

Owner Social Security Number*

Owner Date of Birth*

Do you have a spouse?*

Yes

Spouse Name*

Spouse Drivers License Number & State*

Spouse Social Security Number*

Are there any other owners besides yourself?*

Yes

How many additional owners are there, besides yourself?*

Additional Ownership Information

2nd Owner Name*

2nd Owner % of Stock Owned*

2nd Owner Street Address*

Street Address City State ZIP Code

2nd Owner Driver’s License Number & State*

2nd Owner Social Security Number*

2nd Owner Date of Birth*

Does 2nd owner have a spouse?*

Yes

Spouse Name*

Spouse Drivers License Number & State*

Spouse Social Security Number*

3rd Owner Name*

3rd Owner % of Stock Owned*

3rd Owner Street Address*

Street Address City State ZIP Code

3rd Owner Driver’s License Number & State*

3rd Owner Social Security Number*

3rd Owner Date of Birth*

Does 3rd owner have a spouse?*

Yes

Spouse Name*

Spouse Drivers License Number & State*

Spouse Social Security Number*

4th Owner Name*

4th Owner % of Stock Owned*

4th Owner Street Address*

Street Address City State ZIP Code

4th Owner Driver’s License Number & State*

4th Owner Social Security Number*

4th Owner Date of Birth*

Does 4th owner have a spouse?*

Yes

Spouse Name*

Spouse Drivers License Number & State*

Spouse Social Security Number*

Documentation

Upload a copy of your Articles of Incorporation, Partnership Certificate (if you are a partnership), or Assumed Name Certificate (if you are a proprietorship/DBA):

Drop files here or

Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 20 MB.

Upload a copy of each owner’s, shareholder’s, and principal’s Drivers License:

Drop files here or

Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 20 MB.

Upload your accounts receivable aging or a list of all outstanding invoices:

Drop files here or

Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 20 MB.

Upload your master customer list with names, addresses, and telephone numbers:

Drop files here or

Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 20 MB.

Upload a copy of a sample invoice with backup documentation (UPS #, purchase order, shipping order, signed delivery sheet, etc.):

Drop files here or

Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 20 MB.

Upload copies of all operating authorities and copies of all insurance binders (cargo & PL/PD):

Applicable only if you are a motor freight carrier, cartage company, broker, etc.

Drop files here or

Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 20 MB.

How did you hear about KD Factors?

Full Name*

Typing your full name serves as your signature

Title*

Today's Date*

This field is for validation purposes and should be left unchanged.