CLIENT PROFILE

Please print and fill out the form below and return via fax to: (212) 686-1742 - Fax

Thank You

O.R. Gilbert Enterprises
350 Fifth Avenue., Suite 3304 New York, N.Y. 10118 
(212) 685-1729 - Phone 1-800-858-0939  

Date:______________________________________

Company Name:____________________________ Address:___________________________________ Telephone No:____________
Fax No:___________ Type of Business:____________________________
How Long In Business:_______________________
Monthly Volume:____________________________
Average Invoice Size:________Terms:_________ UCC Filings (Liens):__________________________ Outstanding Bank
Loans:_____________________                                        
_____________________                                        
_____________________                                        
_____________________

 

Customers Name:          Invoices For Factoring:        Total: ________________          ____________________         ______ ________________          ____________________         ______ ________________          ____________________         ______ ________________          ____________________         ______ ________________          ____________________         ______        ________________          ____________________         ______