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Principals:
(All Stockholders with 10%
or more if shares,
Officers, Directors, Partners or Owners).
(Principal 1) Name:
Title:
SS#:
Street Address:
City, State & Zip:
(Principal 2) Name:
Title:
SS#:
Street Address:
City, State & Zip:
(Principal 3) Name:
Title:
SS#:
Street Address:
City, State & Zip:
Gross Sales:
2000
2001
2002
2003
Number of Employees:
Principal Product, Services,
etc:
Typical Invoice Terms:
Average Accounts Receivable
Balance: 30
60
90
Amount of Invoicing to be
Factored:
Number of Customers to be
Factored:
Average Invoice Amount:
Are You Now Using Factoring:
Have You Used Factoring in
the Past:
Your Name:
Your Title:
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