FINAL SUBSCRIPTION AGREEMENT
United Americas Bankshares, Inc.
0000 Xxxxxxx Xxxx
Xxxxxxx, Xxxxxxx 00000
Ladies and Gentlemen:
I hereby subscribe to purchase the number of shares of United
Americas Bankshares, Inc.'s common stock indicated below.
I have received a copy of United Americas Bankshares, Inc.'s
final prospectus, dated __________, 1999. I understand that my
purchase of United Americas Bankshares, Inc.'s common stock involves
significant risk, as described under "Risk Factors" in the final
prospectus. I also understand that no federal or state agency has
made any finding or determination regarding the fairness of United
Americas Bankshares, Inc.'s offering of common stock, the accuracy or
adequacy of the final prospectus, or any recommendation or endorsement
concerning an investment in the common stock.
I am acquiring the shares for investment for my own account and
am not acquiring the shares with a view toward, or for resale in
connection with, any distribution within twelve months of the purchase
thereof. I have no understanding, agreement or arrangement to sell,
distribute, partition, participate or otherwise transfer or assign any
part of the shares to any other person, firm or corporation, and I
have no obligation, indebtedness or commitment that would compel me to
secure funds by the sale of the shares.
I enclose my check in the amount of $10.00 multiplied by the
number of shares I wish to buy. My check is made payable to "The
Bankers Bank - Escrow Agent for United Americas Bankshares, Inc."
When United Americas Bankshares, Inc. receives this agreement and
my check, this subscription will be final and binding and will be
irrevocable until the offering is closed.
Number of Shares
(minimum 100 shares): ___________
Total Subscription Price
(at $10.00 per share): ___________
___________________________________________
Please PRINT or TYPE exact name(s) in which
the shares should be registered
(over)
X-0
XXXXXXXXXX X-0
Under the penalties of perjury, I certify that: (1) the Social
Security Number or Taxpayer Identification Number given below is
correct; and (2) I am not subject to backup withholding. INSTRUCTION:
YOU MUST CROSS OUT #2 ABOVE IF YOU HAVE BEEN NOTIFIED BY THE INTERNAL
REVENUE SERVICE THAT YOU ARE SUBJECT TO BACKUP WITHHOLDING BECAUSE OF
UNDERREPORTING INTEREST OR DIVIDENDS ON YOUR TAX RETURN.
____________________________ ______________________________________
Date Signature(s)*
____________________________ ______________________________________
Street Address Please indicate the form of
ownership desired for the
shares (individual, joint
City/State/Zip Code tenants with right of
survivorship, tenants in
common, trust, corporation,
partnership, custodian, etc.)
____________________________
Area Code/Telephone Number
____________________________
Email Address, if available
____________________________
Social Security or Federal
Taxpayer Identification No.
*When signing as attorney, trustee, administrator or guardian, please
give your full title as such. If a corporation, please sign in full
corporate name by president or other authorized officer. In case of
joint tenants, each joint owner must sign.
TO BE COMPLETED BY UNITED AMERICAS BANKSHARES, INC.
Accepted as of __________________, 1999, as to _______________ shares.
UNITED AMERICAS BANKSHARES, INC.
By: _______________________________
Signature
_______________________________
Print Name
