SHARE PURCHASE ORDER AGREEMENT
(For assistance in filling out this form, please see the reverse side)
To : XxxxxxxxxXxxxxxXxxxxx.xxx, Inc., 0000 Xxxx Xxxxx Xxxx, Xxxxx 000,
Xxxxxxxxx, XX 00000:
Please deposit into "NationsBank, N.A., Escrow Acct No. [ ] " the
attached payment. Upon release of the impound condition, issue shares of
XxxxxxxxxXxxxxxXxxxxx.xxx, Inc. Common Stock in the amount(s) and name(s)
shown below. My signature acknowledges that I have received the Prospectus
by which the shares are offered and that I am purchasing these shares for
investment.
Signature:
Date
Enclosed is payment for [ ] (minimum 50) shares, at $12.00 per share,
totaling $ [ ].
PLEASE MAKE CHECK PAYABLE TO: NationsBank, N.A. Escrow Account No. [ ]
00 Xxxxx Xxxxxx, Xxxxxxxxx, XX 00000
VISA [ ] MASTERCARD [ ]
Number: [ ] Expiration Date: [ ] Signature: [ ]
The only role of NationsBank, N.A. (the "Bank") in this offering is
that of Escrow Agent. The Bank has not reviewed the Prospectus or any of
the offering materials. It makes no representation at all about the nature
of this offering or whether it complies with any legal requirements. The
Bank does not represent the interests of investors. Its duties are limited
to those in the Subscription Escrow Agreement. You may get a copy of that
Agreement from XxxxxxxxxXxxxxxXxxxxx.xxx.
Register the shares in the following name(s) and amount(s):
Name(s) Number of
shares
As (check one):
Individual Joint Tenants Trust
Tenants in Common Corporation Custodial (UGMA) [ ]
Other
For the person(s) who will be registered shareowner(s):
Mailing Address:
City, State & Zip Code:
Telephone Number: Business: ( )
Home: ( )
Social Security or Taxpayer ID Number:
(Please attach any special mailing instructions other than shown above)
NO SUBSCRIPTION IS EFFECTIVE UNTIL ACCEPTANCE
(You will be mailed a signed copy of this agreement to retain for your
records.)
Subscription accepted by XxxxxxxxxXxxxxxXxxxxx.xxx and its sales
representative:
Xxxxx X. Xxxxxxx, Chief Executive Officer
Date
How to Complete the Share Purchase Agreement
How can I purchase shares? Personal check, bank check, money order or
credit card are all acceptable.
Who should sign it? The person who is making the decision to buy shares.
This may be different from the persons in whose names the shares are being
registered.
Whose check can be used for payment? It should be either an account in the
name of the person signing this Share Purchase Order or the name(s) in
which the shares are to be registered. We can not, for instance, accept a
check on a corporate bank account, where the registered shareowner is to be
an individual--unless there is an accompanying certified corporate
resolution authorizing the use of corporate funds for that purpose.
Can I buy shares for more than one person on the same form? Yes, you can
either squeeze in the other names and numbers of shares, or put "see
attached" next to "Name(s)" on the form and put the names and number of
shares on another sheet.
How can I buy shares for a person who is under 18 years old? There are
Uniform Gift to Minors Acts in the states. The "Custodial" box can be
checked and the shares can be registered in a form like: "Xxxx Xxx, as
custodian for Minor Doe, under UGMA." The effect is that Xxxx Xxx can sell
the shares, receive dividends and otherwise manage the investment, until
Minor Doe becomes 18. Then, Xxxx Xxx can request a replacement certificate
in Minor Doe's name. If Xxxx Xxx wants some other legal arrangement, such
as holding the shares until Minor Doe is older than 18, she would have to
create a trust agreement, using a lawyer or a do-it-yourself guide. She
would then check the "Trust" box and fill in the name something like:
"Xxxx Xxx, trustee for Minor Doe," or "Xxxx Xxx, Trustee under Trust
Agreement dated [month,date,year.]"
CanI buy shares for an XXX or other retirement account? If the trust
agreement permits it--that's between you and the trustee. If your trust
agreement does not permit it (many brokerage, mutual fund or bank trustees
will not permit it), then you may be able to "roll over" or open a new
account with another trustee. The check needs to be from the trustee. You
would check "Trust" on the form and write in something like: "[name of
trustee company], trustee for Xxxx Xxx XXX."
Guide to registering investments
Joint Tenants: Two or more persons jointly own Shares. If one person
passes away, all of the shares are transferred to the
surviving partner(s).
Tenants In Common: Two or more persons jointly own Shares. If one person
passes away, half (or whatever individual
fraction) automatically goes to the deceased's estate and not to the
surviving partner(s).
Trust: If you have established a Trust for yourself, Family or Children.
Please be sure to include exact name of Trust and
the Trust's taxpayer ID number.
Custodial: Usually established for a minor, so that an adult can maintain
control/voting rights of the stock until the minor
becomes of legal age (18). Registration should read as follows: Xxxx Xxx
as Custodian for Minor Doe under UGMA. Make
sure to list the minor's social security number, not yours.
Other: 1) Partnership - Make sure to list Tax ID #
2) XXX (Xxxxx, SEP or other retirement plan): Make sure your XXX allows for
investments of this kind, check with your plan administrator. Registration
for all IRA's should read as follows: [(Trustee or name of Plan) as Trustee
for Xxxx Xxx XXX Account # [ ].
