EXHIBIT 4
SUBSCRIPTION AGREEMENT
The undersigned investor herewith subscribes to purchase
shares for $ in the Mortgage
Professionals Lead Source, Inc.(Mortgage) Registered Offering.
The undersigned investor acknowledges that he, she or it has
received and has had an opportunity to review a Prospectus dated
, 2001, pertaining to the sale of the Mortgage shares at $1.00
share. The undersigned further acknowledges that the Prospectus
provides for the opportunity to ask further questions of and to
receive additional information from management of Mortgage, if
the subscriber so elects.
The subscriber understands and agrees that this a "high risk
offering" and has had the opportunity to review the risk factors
contained in the Prospectus.
The subscriber further understands that the funds tendered
to purchase the shares will be held in a segregated subscription
account, pending the sale of the minimum offering for up to 120
days measured from the date appearing on the face of the
Prospectus. The subscriber understands that investor will not be
able to withdraw such funds from the subscription account during
the subscription period, but will receive back all of that
subscription if the minimum offering ($100,000) is not sold
within that term and the offering is terminated. The undersigned
subscriber understands that he will not receive any interest on
the funds held in the subscription account. The subscriber
further understands that in the event the minimum offering amount
of One Hundred Thousand Dollars is sold within the offering term,
then his subscription, as well as any subsequent proceeds
received by the company, will be immediately employed as
described in the Prospectus.
Finally, the undersigned investor understands that the
company is attempting to sell this offering as a self
underwriting through its own officers and without the payment of
any commissions to a third party, underwriter, or broker/dealer.
The subscriber understands that if the company is required to
change those arrangements and to employ underwriters that this
subscription will be rescinded and that the subscriber will have
an opportunity to decide whether to withdraw the funds from the
offering or to reinvest based upon an amended Prospectus setting
out the terms of any underwriting.
Dated this day of , 2001.
Subscriber:
Print Name:
Social Security No.:
Date:
Mortgage/Subscription
