KW Receivables | Application | Learn More About Factoring

Complete The Form Below to Start Turning Your Unpaid Invoices Into Cash

Please enable JavaScript in your browser to complete this form.

- Step 1 of 5

Legal Name of Business *

DBA Name *

Organization Type *

Business Street Address

City *

State *

Zip Code *

Phone *

Email *

State Registered In *

Federal Tax ID *

Number of Owners *

Name of Owner #1 *

Percent Ownership (Owner #1) *

Home Street Address (Owner #1) *

City (Owner #1) *

State (Owner #1) *

Zip Code (Owner #1) *

Phone (Owner #1)

Date of Birth (Owner #1)

Social Security Number (Owner #1)

Name of Owner #2

Percent Ownership (Owner #2)

Home Street Address (Owner #2)

City (Owner #2)

State (Owner #2)

Zip Code (Owner #2)

Phone (Owner #2)

Date of Birth (Owner #2)

Social Security Number (Owner #2)

Name of Owner #3

Percent Ownership (Owner #3)

Home Street Address (Owner #3)

City (Owner #3)

State (Owner #3)

Zip Code (Owner #3)

Phone (Owner #3)

Date of Birth (Owner #3)

Social Security Number (Owner #3)

Name of Owner #4

Percent Ownership (Owner #4)

Home Street Address (Owner #4)

City (Owner #4)

State (Owner #4)

Zip Code (Owner #4)

Phone (Owner #4)

Date of Birth (Owner #4)

Social Security Number (Owner #4)

Name of Owner #5

Percent Ownership (Owner #5)

Home Street Address (Owner #5)

City (Owner #5)

State (Owner #5)

Zip Code (Owner #5)

Phone (Owner #5)

Date of Birth (Owner #5)

Social Security Number (Owner #5)

Name of Owner #6

Percent Ownership (Owner #6)

Home Street Address (Owner #6)

City (Owner #6)

State (Owner #6)

Date #2) (Owner

Zip Code (Owner #6)

Phone (Owner #6)

Date of Birth (Owner #6)

Social Security Number (Owner #6)

Are you currently factoring or have you factored before? *

Who did you work with?

Have you or other owners filed for personal or corporate bankruptcy? *

When was the bankruptcy filed?

Any federal, state or local taxes past due?

How much is due in taxes?

Any judgments or IRS liens against the company or its owners?

How much is due?

Any pending or threatened litigation against the company or its owners?

Total commercial receivables open in $

0- 30 Days Old $

31- 60 Days Old $

61- 90 Days Old $

More Than 90 Days Old $

How many customer accounts would you like to sell? (1-4)

Business Name (Customer #1) *

Website (Customer #1)

Average Monthly Sales (Customer #1)

Average Speed of Pay in Days (Customer #1)

Credit Line Requested (Customer #1)

Business Name (Customer #2)

Website (Customer #2)

Average Monthly Sales (Customer #2)

Average Speed of Pay in Days (Customer #2)

Credit Line Requested (Customer #2)

Business Name (Customer #3)

Website (Customer #3)

Average Monthly Sales (Customer #3)

Average Speed of Pay in Days (Customer #3)

Credit Line Requested (Customer #3)

Business Name (Customer #4)

Website (Customer #4)

Average Monthly Sales (Customer #4)

Average Speed of Pay in Days (Customer #4)

Credit Line Requested (Customer #4)

Signature of Completion *

Please type your name above to affirm completion of the application which serves as permission to KW Receivables for the purpose of accuracy and credit investigation. The statements are true and accurate to the best of my knowledge.

We Provide Instant Cash For Your Commercial Accounts Receivable.

Apply Now

Complete The Form Below to Start Turning Your Unpaid Invoices Into Cash

We Provide Instant Cash For Your Commercial Accounts Receivable.

Menu

Company Information

Legal Terms and Privacy