Gig Factor
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General Business Information
Business Name
Required
Website
Required
Business Street Address
Required
City
Required
State/Province
Select a state/province
Required
Zip/Postal Code
Required
Business Phone Number
Required
Describe your business
Required
Legal Status
Corporation
LLC
Parthership
Sole Proprietorship
Required
Business Articles (Attach File)
Optional
Date Established
Required
Number of Employees
Required
Federal Tax ID/EIN (Attach File)
Optional
Is your business current on all taxes?
Yes
No
Required
Does your business have any tax liens?
Yes
No
Required
Does your business have any outstanding loans?
Yes
No
Required
Outstanding Loan Amount
$
Optional
Lender Name
Optional
Lender Phone
Optional
Anticipated monthly factoring volume
$
Optional
Current accounts receivable balance outstanding
$
Optional
Have you factored before?
Yes
No
Required
If you have factored before who did you factor with?
Optional
How did you find out about Gig Factor?
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Social Media
Other
Optional
Business Signer Information
Use General Business Information
Signer Title
Optional
First Name
Required
Middle Name
Optional
Last Name
Required
Home Street Address
Required
City
Required
State/Province
Select a state/province
Required
Zip/Postal Code
Required
Percent Ownership
Home Phone
Required
Cell Phone
Required
Email
Required
Date of Birth
Required
Social Security Number
Required
Driver's License (Attach File)
Optional
Type your first and last name as a digital signature
Required
Todays Date
Choose "Agree" below to confirm your digital signature
Agree
Required
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