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Empire Factors is a Nationwide finance
lender that provides funding to commercial businesses.

Please fill in the form below.



This business is *:



List the customers you'd like to factor including name, address, monthly billing, and payment terms (we won't contact your customers)



Who do we contact during our evaluation for additional documents and questions?


The undersigned has been told and understands that the submission of an application for factoring with Empire Factors, LLC or our partner Oxygen Funding, Inc., (hereinafter "EF") does not mean that EF will factor or provide financial services whatsoever. The undersigned has been told and understands that approval to factor may come only after the management of EF approves said application and the invoices and financial services accounts offered are approved in accordance with the terms of EF's Factoring and Security Agreement. The undersigned hereby declares that the information provided in this application and its attachments is true and correct to the best of his/her knowledge. The undersigned without further notice hereby authorizes EF to make whatever inquiries or investigations deemed necessary concerning the parties listed herein for the purpose of evaluating this application. EF is also authorized to provide any and all credit information relating to the parties herein to other creditors and/or credit reporting agencies. The undersigned authorizes EF to file any initial financing statements and amendments thereto that: (a) Indicate the collateral as all assets of the undersigned or words of similar effect, regardless of whether any particular asset comprised in the collateral falls within the scope of Article 9 of the UCC, or as being of an equal or lesser scope or with greater detail; (b) Contain any other information required by part 5 of Article 9 of the UCC for the sufficiency or filing office acceptance of any financing statement or amendment, including (i) whether the undersigned is an organization, the type of organization, and any organization identification number issued to the undersigned and, (ii) in the case of a financing statement filed as a fixture filing or indicating collateral as as-extracted collateral or timber to be cut, a sufficient description of real property to which the collateral relates; and (c) Contain a notification that the Seller has granted a negative pledge to the Purchaser, and that any subsequent lienor may be tortuously interfering with Purchaser's rights; A termination statement will be filed in the event EF declines to provide factoring services to the undersigned. The undersigned represents that any and all monies received from EF will be used primarily for business purposes and not for purposes related to personal, family, or household usage.


SIGNATURE *

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Empire Factors LLC
C/O Cohen Saban Charitable Trust
112 West 34th Street
18th Floor, New York
NY 10120

T : 971-MONEY-71
E : info@empirefactors.com
www.empirefactors.com

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