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Dear Client,

Please fully complete this application to the best of your ability. Answer all appropriate questions on this application even if it is a negative issue. You will want to let your new Funding Source know as much as possible. Our job is to help you get the cash you need. Any negative issues are not intended to disqualify you, but to allow us to confront these issues head on. So be accurate and truthful to the best of your knowledge. This is very important. You don't want to waste time, slow down your application, or not receive a quote at all!

Upon completion and submission of this form, you will receive an immediate email with your confirmation and funding source information. Please add “globalquickcapital.com” to your allowed email to ensure delivery.

Please note that these Applications are for conducting cash flow business or applying for loans only! These are not job applications!


Thank you,
GlobalQuick CAPITAL

International Purchase Order Funding Application

Requirements

  • Minimum: $50,000
  • Maximum $5,000,000
  • Accepted Locations: Worldwide
  • Adults 18 and over only

Contact


Contact First Name:

Contact Last Name:

Title:

Email Address:

Phone Number:

Fax Number:

Cell Number:

Company Information


Legal Company Name:

DBA name (if applicable):

Present Company Address


Address 1:

Address 2:

City:

County:

State:

ZIP Code:

Business description:

Website:

Does the company have any other business locations?
 Yes   No

If so, list addresses, phone and fax numbers:

Company Structure


Structure:
 Corporation
 Partnership
 Sole Proprietorship
 LLC

Date Established:
 

State of Incorporation:

Date of Incorporation:
 

Number of employees:

Business Activity:
Distribution
Manufacturing
Assembly
Import
Export
Domestic

Industry:

Specialization (briefly describe nature of business/products sold):

Receivables generated from:
 Goods   Services   Both

Is Office Space Owned or Leased:
 Yes   No

Monthly Rental:

Name of Lender or Leasing Company:

Lender/Leasing Company Phone:

Number of Active Customers:

Number of Invoices Per Month:

Normal Selling Terms:

Extended Terms:

Average Monthly Sales Volume:

Do you currently factor receivables?
 Yes   No

If, Yes, with whom?

Bank References


Name of institution 1:

Address:

Bank Contact:

Bank Phone:


Name of institution 2:

Address:

Bank Contact:

Bank Phone:

Tax Information


How often do you file 941 payroll taxes?
 Weekly   Monthly   Quarterly

Are your federal, state, and payroll taxes current?
 Yes   No

If no, have any tax liens been filed?
 Yes   No

If yes, list the type, quarter/year, and amounts:

Name of Attorney:

Attorney Phone Number:

Name of Accountant:

Accountant Phone Number:

Principal Customers

Please list the company's largest customers for which you need purchase order financing.
(Customers will not be initially contacted.)


Name of Company 1:

Phone:

Address:

Monthly Sales:

Amount of Purchase Order:

Recurring P.O.:
 Yes   No


Name of Company 2:

Phone:

Address:

Monthly Sales:

Amount of Purchase Order:

Recurring P.O.:
 Yes   No


Name of Company 3:

Phone:

Address:

Monthly Sales:

Amount of Purchase Order:

Recurring P.O.:
 Yes   No


Name of Company 4:

Phone:

Address:

Monthly Sales:

Amount of Purchase Order:

Recurring P.O.:
 Yes   No


Name of Company 5:

Phone:

Address:

Monthly Sales:

Amount of Purchase Order:

Recurring P.O.:
 Yes   No

Principal Suppliers

Please list the company's largest suppliers.
(Suppliers will not be initially contacted.)


Name of Company 1:

Phone:

Contact Name:

Address:

Payment Terms:

Average Amount of Past Purchases:

Supplier Since:
  

Detailed Account History:


Name of Company 2:

Phone:

Contact Name:

Address:

Payment Terms:

Average Amount of Past Purchases:

Supplier Since:
  

Detailed Account History:


Name of Company 3:

Phone:

Contact Name:

Address:

Payment Terms:

Average Amount of Past Purchases:

Supplier Since:
  

Detailed Account History:

Transaction Timeline


Day Shipment of Product to Customer:
  

Day 1 Order Received from Customer:
  

Day Product(s) Ordered from Supplier:
  

Day Letter of Credit Issued
(if applicable):
  

Day Product received at warehouse:
  

Day Processing of goods into finished product and distribution
(if applicable):
  

Please explain all value added
(e.g. assembly, repack, labels, etc.):

Cost of Goods Sold


Total Sales:

Product Cost (% of Sales):
 %

Duty/Freight (% of Sales):
 %

Assembly/Production Cost (% of Sales):
 %

Warehousing Cost (% of Sales):
 %

Gross Margin:

Customs Agent:

Customs Agent Phone:

Freight Company:

Freight Contact Name:

Freight Company Phone:

Principals of Company

Principal 1


Principal 1 - Name:

Title:

Date of birth:
  

Address:

How long at this address?

Home Phone:

Percent Ownership:
 %

Years with Company:

Years in Industry:

Ever Declared Bankruptcy?
 Yes   No

If Yes, Year:

If Yes, City/State:

Ever Been Convicted of a Felony?
 Yes   No

If Yes, Year:

If Yes, City/State:

Principal 2


Principal 2 - Name:

Title:

Date of birth:
  

Address:

How long at this address?

Home Phone:

Percent Ownership:
 %

Years with Company:

Years in Industry:

Ever Declared Bankruptcy?
 Yes   No

If Yes, Year:

If Yes, City/State:

Ever Been Convicted of a Felony?
 Yes   No

If Yes, Year:

If Yes, City/State:

Principal 3


Principal 3 - Name:

Title:

Date of birth:
  

Address:

How long at this address?

Home Phone:

Percent Ownership:
 %

Years with Company:

Years in Industry:

Ever Declared Bankruptcy?
 Yes   No

If Yes, Year:

If Yes, City/State:

Ever Been Convicted of a Felony?
 Yes   No

If Yes, Year:

If Yes, City/State:

Principal 4


Principal 4 - Name:

Title:

Date of birth:
  

Address:

How long at this address?

Home Phone:

Percent Ownership:
 %

Years with Company:

Years in Industry:

Ever Declared Bankruptcy?
 Yes   No

If Yes, Year:

If Yes, City/State:

Ever Been Convicted of a Felony?
 Yes   No

If Yes, Year:

If Yes, City/State:

Comments


Additional Comments:

How did you hear about GlobalQuick CAPITAL?

Who Referred You?


No one referred me:

Referred Name:

Referred Phone:

Referred Email:

Application Id:
20241221-070008-205

Please note:
The Funding Source may require copy of additional documents
to make your quote. They will let you know by Email.


Upon submission of this form, you will receive an immediate email with your confirmation and funding source information. Please add “globalquickcapital.com” to your allowed email to ensure delivery.


Privacy Policy & Security

Apply online for a free no obligation quote: Response in 24 to 48 hours in most cases. Our funding sources will be happy to answer all your questions at that time!

We are proud members of the cash flow/growing wealth industry.

We are a
green
company!

We at GlobalQuick CAPITAL believe in giving back to help in this world! A portion of the profits from our earnings will be given to: Heart Research, Arthritis Research, Endangered Animal Species, and Rain Forest Preservation.