EXHIBIT 15
FORM 10-KSB
MOUNTAIN OIL, INC.
MOUNTAIN OIL, INC. - COMMON STOCK
SUBSCRIPTION AGREEMENT
Initial Subscription
Additional Investment: Account Number Previously Assigned:
INVESTMENT
I desire to purchase $ aggregate
principal amount of IBF VI - Participating Income Corporation.
Make Checks Payable to: Bonneville Bank , Mountain Oil, Inc., Escrow Account
Subscriber Information: Please clearly print name(s) in which Shares are to be
acquired. All checks and correspondence will go to the Investor Residence
Address unless specified otherwise in the Check Distribution Section
Investor 1 (First, Middle I., Last):
Investor 2 (First, Middle I. Last):
REGISTRATION FOR THE INVESTMENT (HOW THE INVESTMENT SHOULD BE TITLED):
INVESTOR RESIDENCE ADDRESS 1: CHECK ONE OF THE
FOLLOWING:
U.S. Citizen
Investor Residence Address 2:
Resident Alien
City, State ZIP Code Foreign
Resident; Country ________
U.S. Citizen residing outside
the U.S.
OCCUPATION:
Check Distribution Information (if different):
Financial Institution (Bank, Trust Company, etc.):
Address:
City, State ZIP Code
Account Number:
Enter the taxpayer identification number. For most individual taxpayers, it is
their Social Security Number. Note: If the purchase is in more than one name,
the number should be that of the first person listed. For IRAs, Xxxxxx, and
qualified plans, enter both the Social Security Number and the Taxpayer
Identification Number for the plan.
SOCIAL SECURITY NUMBER TAXPAYER IDENTIFICATION NUMBER (IF
APPLICABLE)
Form of Ownership (Individual, IRA, Trust, UGMA, Pension Plan, etc.)
Broker/Dealer - Registered Representative Information (To be completed by
Registered Representative)
I hereby certify that the investor(s) has read the prospectus and meets the
suitability requirements.
Broker/Dealer Firm Name:
Registered Representative:
Sales Representative Signature:
Subscriber Signature: (the undersigned has the authority to enter into this
subscription agreement on behalf of the person(s) or entity registered above.
I (We) certify under penalty of perjury that this is my (our) correct Social
Security Number (and/or Tax Identification Number) and that interest income on
this account should be reported on this number. I acknowledge and agree to
this statement on the reverse side hereof.
Authorized Signature of Investor 1 Date
Authorized Signature of Investor 2 Date
Company's Acceptance (To be completed only by an authorized representative of
the Company.)
The foregoing subscription is accepted this ____________ day of
________________, _____
___________________________________
Authorized Representative of the
Company
E-51
