England Factoring Application

Language

Prefer Spanish?

Choose your language before you begin. The completed PDF will remain in English.

Before you begin

Have these documents ready

Please have the necessary documents available before continuing.

Driver's License
Certificate of Insurance showing owned units
Truck registration for each owned power unit
Lease agreements (if applicable)
Current Factoring Contract (if applicable)
A/R Aging Report (if applicable)

Step 1

Applicant Information

Start here

Find carrier by DOT or MC

DOT # MC #

Enter DOT or MC, then lookup.

Legal name of applicant DBA / trade name Primary telephone Primary email FF # Federal tax ID DUNS SCAC

Step 2

Company and Address

Mailing address 1 Mailing address 2 City State Zip code

Physical address is the same as mailing

Physical address 1 Physical address 2 City State Zip code

Business type State of organization Date of organization Number of power units Confirm owned power unitsConfirm your owned power units. If different from SAFER, use the correct number. Leased power units Employee drivers Contractor drivers TMS name

Step 3

Current Factoring and Related Businesses

Currently factors Current factor name Outstanding balance Expiration date Applicant related to another transportation business Owner previously owned a transportation business

Applicant related business details

Company name line 1 DOT or MC # line 1 Status

Company name line 2 DOT or MC # line 2 Status

Company name line 3 DOT or MC # line 3 Status

Company name line 4 DOT or MC # line 4 Status

Company name line 5 DOT or MC # line 5 Status

Previously owned business details

Company name line 1 DOT or MC # line 1 Status

Company name line 2 DOT or MC # line 2 Status

Company name line 3 DOT or MC # line 3 Status

Company name line 4 DOT or MC # line 4 Status

Company name line 5 DOT or MC # line 5 Status

Step 4

Owner of Applicant

Contact / owner name Contact phone Contact email Full legal name Title Social Security No. Ownership % Cell phone

Additional owner

Full legal name Title Social Security No. Ownership % Cell phone

Additional owner

Full legal name Title Social Security No. Ownership % Cell phone

Step 5

Customer Volume

Total customers previous 12 monthsIf unsure, enter 0. Average monthly revenue Average monthly loads One customer is 25% or more of volume

Customer concentration company lookup

Company name line 1 DOT or MC # line 1 Status

Company name line 2 DOT or MC # line 2 Status

Company name line 3 DOT or MC # line 3 Status

Company name line 4 DOT or MC # line 4 Status

Company name line 5 DOT or MC # line 5 Status

Company name line 6 DOT or MC # line 6 Status

Company name line 7 DOT or MC # line 7 Status

Company name line 8 DOT or MC # line 8 Status

Company name line 9 DOT or MC # line 9 Status

Company name line 10 DOT or MC # line 10 Status

Step 6

Documents and Signature

Driver license Upload one or more files. If using your camera, take one photo per page. Certificate of insurance Upload one or more files. If using your camera, take one photo per page. Current factoring contract Required if currently factoring. Upload one or more files. A/R aging report Required if currently factoring. Upload one or more files. PDF, image, or Excel accepted. Truck registrations Required based on confirmed owned power units. Lease agreements Required based on leased power units. Additional documents Optional. Select one or more additional documents.

Applicant name Printed name Title Date Applicant signature Applicant initials

Prefer Spanish?

Have these documents ready

Applicant Information

Find carrier by DOT or MC

Company and Address

Current Factoring and Related Businesses

Owner of Applicant

Customer Volume

Documents and Signature

Application Successfully Submitted