Get Started With Greystone Commercial Services Today!

Take the first step in determining if factoring with Greystone Commercial Services is right for your business. Please take a few minutes to fill out our online general application so that we may provide you with a preliminary quote.

General Application

Company Information
Exact Legal Name of Business
Physical Address
Street
City		State	Zip
Phone Numbers
Local	( ) -
Fax	( ) -
Website
Brief description of business
Type of business	Private corporation Public corporation Sole proprietorship Limited liability company General partnership Limited partnership Joint venture Other

Sales Information
Current Open A/R:	$
Last 30 Day Sales:	$
Last 3 Years Sales:
Year 1:	$
Year 2:	$
Year 3:	$
Average Invoice Amount	$
Nbr of Invoices per Month
Last year's dilution (returns, discounts, etc.)	$
Usual term of sale	On receipt Net 10 Net 15 Net 20 Net 30 Net 45 Net 60 Net 90 Net 120 Net 180 Other
Projected Next 12 Months:	$

Ownership - For ALL individuals or corporations reflecting 100% of ownership.
	Name                                                Ownership%
1.
2.
3.
4.

Officers - Please list all officers of the company.
	Name                                                Title
1.
2.
3.
4.

Questions
Please answer "yes" or "no" to each of the following questions. We will obtain related details and/or documents later, if needed.
YES	NO
		Are receivables currently pledged as collateral? If yes, with whom?
		Has the Company ever financed it's A/R before? If yes, with whom?
		Is inventory currently pledged as collateral? If yes, with whom?
		Is the Company currently operating UNPROFITABLY?
		Has there been any change in ownership of the Company within the last 24 months? If yes, explain:
		Is the Company currently involved in civil or criminal judicial, administrative, or arbitration proceeding or is any such action being threatened by anyone? If yes, explain:
		Are there any unsatisfied judgments, liens, or levies against the Company, whether or not of record? If yes, explain:
		Has the Company ever had petition in bankruptcy filed by or against it, or is the Company considering filing bankruptcy or is an involuntary bankruptcy being threatened against it? If yes, explain:
		Does the Company (or any person who owns the Company) owe money to a previous owner of the Company? If yes, explain:
		Are any local, state or federal taxes delinquent, or are there any liens related to such taxes filed or threatened to be filed, or is the Company presently under any installment agreements (oral or written) for the payment of such taxes? If yes, explain:
		Is the Company regulated by any Government Agency? If yes, explain:
		Is the Company or has the Company ever used any name, either legal, assumed, fictitious or trade name other than the legal name listed above? If yes, explain:
		Does the Company purchase goods or services from any firm it also sells to?
		Does the Company have any Progress Billing prior to completion/delivery?
		Does the Company have any Retention Billing?
		Does the Company have Sales to Affiliates?
		Does the Company accept Customer Deposits?
		Does the Company Bill Now but Hold customer merchandise on your premises for shipment later?
		Does the Company have any Guaranteed or Consignment Sales?
		Does the Company charge Sales Tax to its customers?

Submitted by
Name
Title
Phone	( ) - Ext.
Email

When may we contact you?
Immediately Mon - Fri Saturday Date entry or Date: / / Between 6 AM 7 AM 8 AM 9 AM 10 AM 11 AM 12 AM 1 PM 2 PM 3 PM 4 PM 5 PM 6 PM 7 PM 8 PM 9 PM and 6 AM 7 AM 8 AM 9 AM 10 AM 11 AM 12 AM 1 PM 2 PM 3 PM 4 PM 5 PM 6 PM 7 PM 8 PM 9 PM

The information submitted herein is true and correct to the best of my knowledge and is submitted to Greystone Commercial Services LP (GCS) to induce GCS to provide financing to applicant. By clicking submit, on behalf of the applicant, hereby (A) authorizes GCS and any of it employees, agents and representatives to request and obtain any records and/or other information relative to the applicant of a criminal or civil nature (including any credit reports or other such records and/or information on the creditworthiness of the applicant) and (B) releases and indemnifies GCS, its owners, officers, employees, agents and representatives, as well as party supplying such records and information to GCS, from any liability with respect to requesting, obtaining and/or supplying such records and other information on the applicant.