SUBSCRIPTION AGREEMENT INVESTOR SUBSCRIPTION AGREEMENT FOR SILVER STAR CAPITAL HOLDINGS, INC.
Persons
interested in purchasing shares of Silver Star Capital Holdings, Inc. must
return this completed subscription agreement along with a wire transfer, check
or money order for their total payment, payable only to:
SILVER
STAR CAPITAL HOLDINGS, INC
0000
Xxxxxx Xxxx Xxxx
Xxxxx
000
Xxxxxxx,
Xxxxxxx 00000-0000
If
and
when accepted by us, this subscription agreement shall constitute a subscription
for shares of our common stock.
An
accepted copy of this agreement will be returned to you as your receipt, and
certificates for your stock will be issued to you shortly
thereafter.
Method
of
payment: [ ] Check, [ ] Money Order,
[ ] Wire payable only to: Silver Star Capital Holdings,
Inc.
Wire
Transfer Instructions:
Bank:
Bank of America Address: Orlando, Florida ABA: 000000000 Account Name: Silver
Star Capital Holdings, Inc. Account Number: 8980 0263 0211
Reference:
(Insert Subscriber’s Name)
I
hereby
irrevocably tender this subscription agreement for the purchase
of
shares at $1.50 per share. With this subscription agreement, I tender payment
in
the amount of
$
for the shares subscribed.
In
connection with this investment, I represent and warrant as
follows:
(a) Prior
to tendering payment for the shares, I received your final prospectus dated
[insert date].
(b)
I am a bona fide resident of the state of . Please issue the securities, which
I
am purchasing as follows: Individual(s)—if more than one owner, please issue
as follows:
[
] Tenants-in-Common (all parties must sign--each investor has
an undivided interest)
[
] Joint Tenants with Right of Survivorship (all parties must
sign--joint ownership)
[ ] Minor with adult custodian under the Uniform Gift to Minors Act in
your state (the minor will have sole
beneficial ownership) ________________ (minor's name)
SUBSCRIPTION
FORM FOR OTHER THAN INDIVIDUAL
Purchasers
of shares of Silver Star Capital Holdings, Inc., other than individuals, must
complete this form for the proper entity that will hold title to the
shares. Send this completed subscription agreement along with
a a wire transfer, check or money order for their total payment,
payable only to:
SILVER
STAR CAPITAL HOLDINGS, INC
0000
Xxxxxx Xxxx Xxxx
Xxxxx
000
Xxxxxxx,
Xxxxxxx 00000-0000
If
and
when accepted by us, this subscription agreement shall constitute a subscription
for shares of our common stock.
An
accepted copy of this agreement will be returned to you as your receipt, and
certificates for your stock will be issued to you shortly
thereafter.
Method
of
payment: [ ] Check, [ ] Money Order,
[ ] Wire payable only to: Silver Star Capital Holdings,
Inc.
Wire
Transfer Instructions:
Bank:
Bank of America Address: Orlando, Florida ABA: 000000000 Account Name: Silver
Star Capital Holdings, Inc. Account Number: 8980 0263 0211
Reference:
(Insert Subscriber’s Name)
I
hereby
irrevocably tender this subscription agreement for the purchase
of
shares at $1.50 per share. With this subscription agreement, we tender payment
in the amount of
$
for the shares subscribed.
In
connection with this investment, I represent and warrant as
follows:
(a) Prior
to tendering payment for the shares, we received your final prospectus dated
[insert date].
(b)
Our
entity is domiciled in the state of .
ENTITY:
[
]
CORPORATION (authorized agent of the corporation must
sign)
[
] EXISTING
PARTNERSHIP (at least one partner must sign)
[
]
TRUST (all trustees must sign)
Name
of
Entity
Authorized
Agent (print name above)
Title
of
Authorized Agent
Social
Security or Federal Identification Number of Entity
Street
(business address) or address of Registered Agent
City
State Zip Code
Business
Telephone or Home Telephone of Registered Agent
Fax
E-mail
The
undersigned acknowledges that the foregoing information is true, accurate,
and
complete.
Name
Date
For a Trust, all Trustees must sign. Add a line for each
ACCEPTED
BY: Silver Star Capital Holdings, Inc.
Cliffe
X.
Xxxxxx, President Date
Investor
Xx. 0 Xxxxxxxx Xx.
0
Xxxxxx
(xxxxxxxxx address)
Street (residence address)
City
State Zip Code City State
Zip Code
Home
Phone Business Phone Home
Phone Business Phone
Social
Security Number Social
Security Number
Signature
Date Signature
Date
ACCEPTED
BY: Silver Star Capital Holdings, Inc.
Cliffe
X.
Xxxxxx, President Date
