____________________________, 20_____
_____________________________________
(City/Town) (State)
Gentlemen:
I/ we hereby authorize
__________________________________________________________
hereinafter described as the Borrower, to pledge as collateral security for the payment of any and all loans now or hereafter made by you to the borrower, and for any and all renewals thereof, and for the payment of any direct or indirect liability of the Borrower's to you, due or to become due, or that may hereafter be contracted, and for the payment of any note or notes now or hereafter given by the Borrower to you, and upon the terms stated therein, the following securities of other property belonging to me/ us, or of which I/ we am/are the holder of record, namely:
__________________________________________________________
__________________________________________________________
_________________________________________________________
__________________________________________________________
_________________________________________________________
__________________________________________________________
Also any securities or other properties of mine/ ours or of which I/ we am/are the holder of record, which the Borrower may hereafter deposit with you for the purposes aforesaid; and I/ we do hereby give you the same powers with respect to said securities or other property as is contained in any note or notes given you as aforesaid by said Borrower, hereby authorizing you to deal with said securities or other property in the same way and with the same force and effect as if said securities or other property pledged by said Borrower as collateral security therefore had belonged to said Borrower. I/ we represent that all of said securities and/or other property are unencumbered and free of any restriction upon resale.
I/ we also authorize you to deliver to said Borrower the said securities or other property, or any part thereof, whenever you may wish, and the Borrower's receipt shall be your sufficient acquittance therefore, meaning and intending to authorize said Borrower to act with said
securities or other property as if the Borrower were the absolute owner thereof.
Very truly yours,
_____________________________________________ Seal
_____________________________________________ Seal
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