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To get started, please complete the below information. We will contact you immediately and advise what additional materials are needed and how the process will proceed.
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| Applicant Information |
| Company Name: |
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| Address Street 1: |
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| Address Street 2: |
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| City: |
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| Zip Code: |
(5 digits) |
| State: |
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| Contact Information |
| Contact Name: |
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| Phone: |
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| Email: |
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| Business Information |
| How long have you been in business?: |
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| Industry: |
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| Monthly Receivable Volume: |
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| Typical Receivable Size: |
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| Total Number of Customers: |
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| Financial Information |
| Annuals Revenues: |
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| Any existing Bank or Credit Lines?: |
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| Is there a lien on your assets?: |
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| Are you in Default or Seriously Late with payments to Banks, Creditors, Tax Collector, others?: |
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| Do you have Financial Statements available?: |
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| Any Pending LItigation or Judgments?: |
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| Check Here |
The above information has been submitted by an authorized company representative or broker consultant and is true and correct to the best of my
knowledge.
Upon clicking the 'Submit and Authorize' button below, Tortugas Finance Corp. or its agents are authorized to verify and investigate any and all
the above statements. |
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