HFF CAPITAL - FUNDING REQUEST

Innovative Business Solutions

Asset Based Lending Request

Company Name:

Company Address:

Years in Business:

Last 12 mo. Revenues (approx.) $:

Your Name:

Title:

Telephone:

Fax:

E-Mail:

How Did You Hear About Us?

If Other:

Type Of Entity:

Type Of Business:

Primary Line Of Business:

Year Incorporated:

State Incorporated

Average Invoice Amount:

Average Number Of Invoices a Month:

Number Of Employees:

Years Of Current Ownership:

Funding Needed $:

Date funding is required:

Comments:

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