$ Nutech Capital Resources $ Contract Receivables Application

First Name:
Last Name:
Company Name:
Your Title:
Business Street Addrs:
City:
State:
Zip:
Country:
Phone:
Fax:
e-mail:

Business Structure:

State
No. of Owners/Partners:
Years in business?yrs
Company Function?
Annual sales volume? $
Typical Contract Size? $
Who are your best customers?


What is your Gross operating Profit Margin?%
Do you have a bonding line?yes no
If yes, amount per job or contract? $
Total limit? $
Have you a ever defaulted on a contract or bond? yes no
Name of your bonding agent?
Are there any liens against your company? yes no
Do you owe any back taxes?yes no
Do you have a line of credit with a bank? yes no
Do you have ready access to:
Recent Tax Reports? Federal? yes no
State?yes no
Personal?yes no

Questions, Requests, Comments:

When completed please click on the submit button below:

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Nutech Capital Resources \| P. O. Box 305, Brownsville \| California \| 95919 \| USA
Ph: 530-675-9151 \| Fax: 530-675-9152 \| e-mail: Richard@NutechCapital.com
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