No risk to apply!

There's no obligation and no fee for applying. You will not be charged any fee until you use the service. Even then, your fees will be deducted from payments we receive. No out-of-pocket costs to you!

Your info is private.

AFS fully respects your privacy. We will never sell or rent any of your contact information.

Once you've submitted the application, a FastCash representative will contact you, giving you an opportunity to ask any questions about the program.

Questions about this application?
Call us at 1-877-472-7653 from 9 AM - 6 PM EST.

Section 1. Personal Information

(Must be a company Principal, authorized to enter into contract on behalf of the company, and to sign checks and approve invoices for payment.)

•Indicates required field.

•First Name
 •Last Name
•Primary E-Mail
 Secondary E-Mail
•Home Street Address
 Apt./Suite No.
•City
•Zip/Postal
•Country
•Phone Number
 Fax Number
Years working in this industry

Section 2. Business Information

Fill in the following fields wherever they apply to you. Fill in the business address if different from the above address.


Business Name
(exact legal name)
 Business URL
Business Address
(no P.O. Boxes)
 Suite/Floor
City
 State
 Zip/Postal Code
Phone Number
 Fax Number
Tax ID Number
(if corp. or LLC)
 •Year Business Started
 State of Incorporation
•Business Type (choose one):
Proprietor
LLC
Corporation
Partnership
•Description of Services/Products Your Business Offers
     
•Total Sales
Last Fiscal Year
 •Current Monthly
Sales Volume
 •Year-to-Date
Sales Volume
     
For the next 2 fields, list a dollar figure, or range, if you prefer.
•Average Invoice
Dollar Amount		 •Average number of invoices that you plan to send through FastCash per month
•Do you contract directly with the company you invoice, or is there another party involved (e.g., a broker, agent, or partner)?
Always directly
Sometimes another party is involved (if so, explain below)
•When do you bill for your work (e.g., end of the project, progress billing, weekly, monthly, up-front, etc.)?
Name of Other Owner of company (if applicable)
 Percent owned by Other Owner

Section 3. Professional Advisors


List your company's outside accountant, attorney, consultant, banker (when applicable).

1. First Name
 Last Name
  Company Name
 Phone Number (with area code)
     
2. First Name
 Last Name
  Company Name
 Phone Number
     
3. First Name
 Last Name
  Company Name
 Phone Number

Section 4. Invoice Submission Information

List the names of three clients that you anticipate billing through FastCash. This is not a binding list; it's intended to help us understand your business and the companies you serve.

1. •Client Name
 
 
•How Often Invoiced (approximately)
   •Average Invoice Amount
  •Invoice Payment Terms (e.g., net 30, net 60, etc.)
Note: please indicate if payment is contingent on some other event (payable upon publication, payment contingent on payment from another party, etc.)
  Client City, State
   
2. Client Name
 
How Often Invoiced
   Average Invoice Amount
  Invoice Payment Terms
  Client City, State
   
3. Client Name
 
How Often Invoiced
   Average Invoice Amount
  Invoice Payment Terms
  Client City, State

How did you hear about Aquent FastCash?

A FastCash Member told me about it. Name:
 
Search
 
I read about it in .
 
I clicked on a link that I saw on .
 
Other:
 

Section 6. Credit Release Form*

Credit Release Agreement
I authorize Aquent to check my personal credit report. I understand that Aquent will not share this information with any individual or company. The information from the report will be used for internal purposes only.
Yes. I authorize Aquent to review my personal credit report.
Social Security Number
If you would rather not submit your Social Security Number online, we offer two alternatives:

1. Call us at 800-878-0900 x5023 (9am to 6pm EST).
Ask for Mark, Business Manager of Aquent Financial Services, and he can take your information over the phone.

2. Download our Credit Release Form.
After clicking the submit button below, you will receive an email acknowleging receipt of your application. Attached to the email will be a PDF of our credit release form that you can download, print, complete and fax back to us (fax cover sheet provided).

* We check the credit of all applicants to Aquent FastCash. We require the personal credit information of a principal, preferably the same principal mentioned in Section 1. The credit of a prospective member is considered with equal weight along with references, general information, and potential clients. Poor credit does not always result in a declined membership.