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(865) 338 – 3899
sales@tagcapfunding.com
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(865) 338 - 3899
sales@tagcapfunding.com
tagcapfunding.com
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4
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1. Application Information
Name
*
Email
*
Phone
*
2. Business Information
Exact Legal Name of Business
*
Trade Name or DBA
*
Federal ID #
*
Business Address
*
Website Address
*
Business Type
*
Year Established
*
3. Ownership Information
1. Has there been a change in ownership in the last 12 months or a change of name of business?
*
Yes
No
2. If yes, please explain?
*
3. Does the business or any of the owners have any lawsuits pending at this time?
*
Yes
No
4. Do any of the owners owe back taxes?
*
Yes
No
5. Does the company currently have a lien against the company?
*
Yes
No
6. Average Number of invoices to be Factored per month
*
7. Average Amount to be Factored Per Month
*
8. Has this company or its principals ever filed bankruptcy?
*
Yes
No
4. Distributors and Case Count Information
1. List of Distributors with current PO's
*
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Select files
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2. Where is the company currently bottling?
*
3. List of current Distributors
*
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Select files
Accepted file types: pdf, Max. file size: 100 MB.
4. Prior Year Case Count
*
5. Expected Case Count for current year
*
(865) 338 - 3899
sales@tagcapfunding.com
