Securities Based Lending

articesupport--

Dallas
254.865.6339

Atlanta
770.888.8063

Quote Request

Please complete the form below and we will respond quickly. Please note: Retirement funds (401k's, IRA's, and other restricted accounts) do not qualify for this program and our minimum loan amount is $100,000.

Client's Name:

Requested Loan Amount:
Desired Loan Term:	3yr 5yr 7yr 10yr
Eligible Securities to Pledge:
You may complete the information requested below of if you prefer you may email us your borrowers Broker Position page (last monthly statement).

Number of Shares	Name of Securities	Stock Symbol (if known)

Referring Broker (If Applicable):

Broker Phone #:

Broker Email:

Loan Origination Fee Desired:

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