Exhibit 1.4
PURCHASE AGREEMENT FOR SHARES OF COMMON STOCK
(For assistance in filling out this form, please see the reverse side)
Mail Completed Form to:
Cornerstone Ministries Investments, Inc. , Investor Services
0000 Xxxxxxx Xxxxxxx, Xxxxx 000, Xxxxxxx, XX 00000
Please issue shares of the common stock of Cornerstone Ministries
Investments, Inc. in the amount and name shown below. I have received and had an
opportunity to read the Prospectus. I certify (i) that the number shown on this
form is my correct taxpayer identification number, and (ii) that I am not
subject to backup withholding.
Signature:_________________________________________ Date___________________
Signature: ________________________________________ Date___________________
Enclosed is payment for purchase of ________ shares of common stock,
at $10.00 per share $ __________
Make checks payable to: Cornerstone Ministries Investments, Inc.
Register the shares in the following name(s):
Name(1) ____________________________ Social Security or Taxpayer ID
Number_______________Birthdate_______ Name (2)___________________________ Social
Security or Taxpayer ID number_______________
As (check one): Individual ___ Joint Tenants ___
Custodial (shares owned by minors) ___ Tenants in Common ____
Corporation ___ Trust ___ Other ___
RETIREMENT ACCOUNT ( ) Traditional XXX ( ) Xxxx XXX ( ) XXXXX
------------------
Custodian:__________________________________
Mailing Address for the person(s) who will be registered shareowner(s):
Address: __________________________________________________________________
City, State & Zip Code: ____________________ e-mail address: ______________
Telephone Number: Business: (___) ______________ Home: (___) ____________
Yes, I want to save the cost of printing and mailing financial reports,
proxy statements, and other documents. Please send all certificate holder
communications to my email address. Signature: _________________________________
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 Cornerstone Ministries Investments, Inc.
and its sales representative:
Xxxxx Xxxxxxx, Xx. Vice President __________________________ Date_____________
Broker/Dealer __________________________ Broker ______________________________
Share Purchase Agreement page 2
How to Complete the Share Purchase Agreement
Make checks payable to: Cornerstone Ministries Investments, Inc.
How can I purchase a shares? Personal check, bank check, or money orders are the
only acceptable forms of payment. No cash or credit cards are accepted.
Who should sign it? The person who is making the decision to buy the shares.
This may be different from the person in whose name the certificate is being
registered.
Whose check can be used for payment? It should be either an account in the name
of the person signing this purchase agreement 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? No. Make a copy of
the form to use for an additional investment.
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 you want some
other legal arrangement, such as holding the shares until the minor is older
than 18, you would have to create a trust agreement, using a lawyer or a
do-it-yourself guide. You 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 November 29, 1997."
Can I purchase shares for an XXX or other retirement account? If your trust
agreement permits it--that's between the investors and their trustees. If your
trust agreement does not permit it (many brokerage, mutual fund or bank trustees
will not permit it), then you may choose 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: "ABC Company, trustee for Xxxx
Xxx XXX."
Guide to registering investments
Joint Tenants: The shares are jointly owned by two or more persons. If one
person passes away, all of the shares are transferred to
the surviving partner(s).
Tenants In Common: The shares are jointly owned by two or more persons. If one
person passes away, half (or whatever fraction designated
of the shares) automatically goes to the deceased's estate
and not to the surviving partner(s).
Trust: If you have an established Trust for yourself, Family or
Children. Please be sure to include exact name of the Trust
and the Trust's taxpayer ID number.
Custodial: Usually established for a minor, for a Guardian to maintain
control of the shares 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 trust agreement
allows for investments of this kind, check with your plan administrator. If not,
you can establish a new XXX. Registration for all IRA's should read as follows:
[(Trustee or name of Plan) as Trustee for Xxxx Xxxxx XXX Account # _________]
