APPLICATION – Request for Securities-Based Loan Quote

Please include/attach a copy of your current brokerage statement.  Quote Requests without a brokerage statement included will not be processed.

Our pre-underwriting staff reviews Applications in the order each is received.  If sufficient information is provided, response time is usually 1-3 banking days, subject to the current volume of Quote Requests submitted.

1. Borrower's Information
2. Your Full Name(required)
3. Company Name
4. Address (include street, city/state/province, postal code)(required)
5. Valid Email Address(valid email required)
6. Daytime Phone Number (please include country)(required)
7. Fax Phone Number
8. Are you the owner of the securities you are inquiring about? (Advisors, Brokers, Consultants & Intermediaries are welcome) --Select One-- Owner Other (required)
9. If Not Owner, Please Explain
10. If not the owner of the securities, please provide your contact information below:
11. Your Full Name
12. Company Name
13. Address (include street, city/state/province, postal code)
14. Valid Email Address
15. Daytime Phone Number (please include country)
16. Fax Phone Number
17. Securities Information
18. Are you an employee, director, insider, or 10% beneficial owner for any of the securities being pledged? --Select One-- Yes No (required)
19. Please explain
20. Are any of your securities currently in Certificate ("Cert") form? --Select One-- Yes No (required)
21. Please explain
22. Are your securities free-trading? --Select One-- Yes No (required)
23. Please explain
24. Are any of your securities currently being used as collateral for a loan? --Select One-- Yes No (required)
25. Please explain
26. Are there currently any third party claims to any of your property (i.e., tax lien, divorce settlement etc)? --Select One-- Yes No (required)
27. Please explain
28. What type of account do you have? (ie.,personal, business, trust)(required)
29. Where are your securities currently held? (Brokerage firm)(required)
30. Are any of your securities held in a 401K, IRA or other managed pension plan? --Select One-- Yes No (required)
31. If Yes, how much?
32. What is the approximate value of your portfolio in: (Not including 401K, IRA or other managed pension plans)
33. Stocks $
34. Bonds $
35. Mutual Funds $
36. Other $
37. What loan (Line of Credit) amount are you requesting(required)
38. Please attach a copy of a driver's license or passport, as well as your most recent brokerage account statement.
39. Upload your recent brokerage account statement(required)
40. Upload you driver's License or passport(required)
41. I have read and understand the INFORMATION PROTECTION AND PRIVACY POLICY NOTICE linked and provided by CFG above. --Select One-- Yes No (required)
42. I attest by my initials here that the information given in this application is truthful and accurate. (please initial)(required)

 

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