ORDER FORM
Broker Name
*
Broker Phone Number
*
Format: (000) 000-0000.
Broker E-mail
*
Customer Company Name
*
Address 1
*
Address 2
City
*
State
*
Please Select
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
*
Date Business Filed
*
EIN
*
Select Tradeline Amount
*
Please Select
50,000
100,000
150,000
200,000
250,000
Custom Request
Select Tradeline Aging:
*
Please Select
NEW
AGED
Select Tradeline Type:
*
Please Select
Term Loan
Auto
Revolving
Real Estate
Equipment Lease
Agreement
(By checking these boxes you are agreeing to our terms - any questions please contact us)
Agreement and Terms
*
New Lines have a 97% balance at posting and are paid down to 25% (90 Day Process)
New Line Price = 1.5% (Ex: 100,00 Tradeline x 1.5% = 1,500.00)
Aged Lines are 12-24 months old and are paid down to 25% balance (30 Day Process)
Aged Line Price = 3% (Ex: 100,00 Tradeline x 3% = 3,000.00)
Payment is due upfront via Zelle only
Zelle info: admin@thebfpteam.com (Axiom Group Holdings)
Pleasse put only Company Name in Memo
Signature
Enter the word as it's shown
*
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