KD Factors & Financial Services | Factoring Company in Grapevine, Texas
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Basic Company Information
Legal Name Of Company
*
Federal Tax ID
*
Major Business
Phone Number
*
Fax Number
Email
*
Company Street Address
*
City
State
TX
AL
AK
AR
AZ
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
UT
VT
VA
WA
WV
WI
WY
Zip Code
Company Mailing Address the Same as Physical?
*
Yes
No
Company Mailing Address
*
City
*
State
TX
AL
AK
AR
AZ
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
UT
VT
VA
WA
WV
WI
WY
Zip Code
Business Type
*
Partership
Proprietership
Corporation
State of (if Corporation)
Texas
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Date Business Started
*
Any Ownership Change in Last 2 Years?
*
Yes
No
Ownership Changes in Last 2 Years Explanation
*
Restate the problem title and/or include more descriptive summary information.
Has the Business Name Changed Within the Last 2 Years?
Yes
No
Explanation of Business Name Change
Has The Business Type Changed in Last 2 Years? (e.g. from Proprietorship to Corporation)
*
Yes
No
Explanation of Business Type Changes
Banking Information
Name of Bank
Name of Bank Officer
Bank Officer Phone Number
Bank Address
Bank City
Bank State
Texas
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Bank Zip Code
Do You Have an Accountant Outside of Your Company?
*
Yes
No
Accountant Name
Accountant Phone Number
Accountant Address
Accountant City
Accountant State
Texas
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Accountant 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
No
Name of the Company you are Currently Factoring With:
Are Your Receivables Pledged as Collateral?
*
Yes
No
To Whom Are They Currently Pledged?
Are Your Taxes Current?
*
Yes
No
If Taxes are Not Current, Please Explain:
Ownership Information
Are There Any Other Owners Besides Yourself?
Yes
No
Number of Additional Primary Owners (Besides Yourself)
*
1
2
3
Owner Name
*
Owner Drivers License Number
*
Owner Home Street Address
*
Owner Home City
*
Owner Home State
Texas
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Owner Home Zip Code
*
Owner SSAN#
*
xxx-xx-xxxx
Owner Data of Birth
*
Do You Have a Spouse?
*
Yes
No
Spouse Name
*
Spouse's Drivers License Number
*
Spouse SSAN#
*
xxx-xx-xxxx
Additional Ownership Information
Second Owner Name
Second Owner % of Stock Owned
Second Owner Street Address
Second Owner City
Second Owner State
Texas
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Second Owner Zip Code
Second Owner SSAN#
xxx-xx-xxxx
Second Owner Drivers License#
Does Second Owner Have a Spouse?
Yes
No
Second Owner Spouse Name
Second Owner Spouse SSAN#
xxx-xx-xxxx
Second Owner Spouse Drivers License #
Owner SSAN#
*
xxx-xx-xxxx
Second Owner SSAN#
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