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800.727.3377

Steelhead Finance

  • Steelhead Finance
  • LOGIN
  • Services
    • Factoring for Trucking
    • Factoring for Brokers
    • Factoring for Business
  • Benefits
    • Fuel Card Programs
    • Authority Setup
    • Referral Program
    • Industry Discounts
  • About
    • Who is Steelhead
    • Factoring FAQ
    • Careers
    • Contact Us
  • Call: 800.727.3377

Factoring Application - Tyler Woodard

Company Information

Entity Type(Required)

Freight Details

Types of Business (if both apply, check both)(Required)
Do You Have a List of Customers You Work With?(Required)
Do You Double Broker?(Required)

Person With Significant Responsibility For Above Company

Individual who has significant responsibility for managing the legal entity listed above (e.g., President, Vice President, Managing Member, Chief Executive Officer, etc)

MM slash DD slash YYYY
US Citizen(Required)

Owner, Officer, & Partner (not listed above)

MM slash DD slash YYYY
US Citizen(Required)
Additional Owners?

Additional Owner, Officer, & Partner (Not Listed Above)

MM slash DD slash YYYY
US Citizen(Required)
Additional Owners ?

Additional Owner, Officer, & Partner (Not Listed Above)

MM slash DD slash YYYY
US Citizen(Required)

Legal Considerations

Does the applicant or owners have any past due taxes or tax liens?(Required)
Does the applicant or owners have any bankruptcies, claims, or lawsuits pending?(Required)
Does the applicant or owners have any other factoring/credit applications pending?(Required)

DECLARATION

I, the undersigned opening this account, hereby certify to the best of my knowledge that the information provided above is complete and correct. This certification also includes all forms and documents submitted to Steelhead Finance ("Steelhead") in connection herewith. I/We have been told and do understand that the submission of an application for Financial Services with Steelhead does not mean that Steelhead will provide any financial services whatsoever.

I/We further have been told and do understand that approval may come only after the management of Steelhead approves said application and the financial services offered are approved in accordance with the terms of Steelhead's Agreement with Client.

I/We understand that I/we may be responsible for any hard costs associated with processing this application. In support of this Application, Steelhead is hereby authorized to obtain personal and business credit and/or financial information from my/our bank(s), insurance company, accountant, and other financial institutions or commercial firms with whom I/we have done business as well as credit reporting agencies. It is understood that any such credit and/or financial information will be held in strict confidence and used only in consideration of this Application. As inducement for Steelhead to process this application, Applicant grants to Steelhead a security interest in their accounts receivables.

I/We understand that in the event the Program Offer is terminated by Client after written or verbal acknowledgement, Client shall pay Steelhead the sum of two hundred fifty dollars ($250), which the Parties agree fairly represents the costs and expenses Steelhead will incur in releasing the UCC-1 filed pursuant to the Program Offer, and the Parties further agree that said sum does not constitute a penalty.



I Agree to the Terms & Declaration(Required)
I Agree to the Terms & Declaration
I Agree to the Terms & Declaration
I Agree to the Terms & Declaration
Steelhead Finance

3518 Heathrow Way, Medford, OR 97504 | 800.727.3377

3518 Heathrow Way, Medford, OR 97504

800.727.3377

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800.727.3377
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