Accounts Receivable Financing Application | NTIB Finance & Consulting

A/R Financing Application

Secure form · Your data is kept confidential

Contact Information

Contact Name *Please enter your name.

Business Name *Please enter your business name.

Email Address *Please enter a valid email.

Phone Number *Please enter your phone number.

Entity Type

Annual Revenue

State

Owner's Approximate Credit Score *Required.

Years in Business

Accounts Receivable Details

Receivables Overview

Total Outstanding A/R *Current total balance of all unpaid invoicesPlease enter your total A/R balance.

Average Invoice SizeTypical value of a single invoice

Number of Active Customers / Debtors

Standard Invoice Payment Terms

A/R Aging Breakdown (approximate % by age bucket)

0-30 days

31-60 days

61-90 days

Over 90 days

What percentage of your total A/R is over 90 days old? *

Please enter the percentage over 90 days.

Industry / Type of CustomersA/R financing typically requires business (B2B) debtors

Amount of Capital Needed *Required.

Do you currently have any existing A/R financing or factoring in place? *

Please select an option.

Required Documents

Please email the following documents to complete your application

Aged Accounts Receivable Report

Current A/R aging schedule showing all outstanding invoices by customer, broken down by 0-30, 31-60, 61-90, and 90+ day buckets.

Required

Aged Accounts Payable Report

Current A/P aging schedule showing all outstanding balances owed to vendors and suppliers.

Required

Email documents to: mike@ntibfin.com · Please include your business name in the subject line.

Additional Information or Message

Supporting Documents (optional)

Upload any documents that may help with your application — tax returns, bank statements, financial statements, equipment appraisals, or other supporting materials. Up to 5 files, 10MB each. Accepted: PDF, DOC, DOCX, XLS, XLSX, JPG, PNG.

Click to browse or drag & drop files here

Up to 5 files · PDF, DOC, XLS, JPG, PNG · Max 10MB each

Signature *

By signing below, you certify that the information provided in this application is true and accurate to the best of your knowledge.

Sign above using your mouse or finger

We'll respond within 1 business day · 914.419.3059

Application Received!

Thank you. A member of our team will be in touch within one business day.

Don't forget: Please email your Aged A/R and Aged A/P reports to mike@ntibfin.com with your business name in the subject line.

Questions? Call 914.419.3059.