EXHIBIT 4.1
MSH ENTERTAINMENT CORPORATION
SUBSCRIPTION AGREEMENT
Persons interested in purchasing shares of the Common Stock of MSH
ENTERTAINMENT CORPORATION (the "Shares") must complete and return this
Subscription Agreement along with their check or money order to MSH
ENTERTAINMENT CORPORATION, 000 Xxxxxxx Xxxxxx, Xxx Xxxxxxxxx, XX 00000. If and
when accepted by MSH ENTERTAINMENT CORPORATION, a Utah corporation (the
"Company"), this Subscription Agreement shall constitute a subscription for
shares of Common Stock of the Company.
An accepted copy of this Agreement will be returned to you, and a stock
certificate will be issued to you shortly thereafter. Method of Payment:
Check, Money Order or Wire Transfer payable to "MSH Entertainment Corporation".
I hereby irrevocably tender this Subscription Agreement for the purchase of
_______ Shares at $_____ per Share. With this subscription Agreement, I tender
payment in the amount of $ _______ ($______ per Share) for the Shares
subscribed.
In connection with this investment in the company, I represent and warrant as
follows:
(a) Prior to tendering payment for the Shares, I received the Company's
Prospectus dated _____________________ __, 1997.
(b) I am a bona fide resident of the state of ________________________.
Please register the Shares which I am purchasing as follows:
1. 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
____________________________________
INVESTOR NO. 1 (print name above)
____________________________________
Street (residence address)
____________________________________
City State Zip
____________________________________
Home Phone
____________________________________
Social Security Number
____________________________________
Date of Birth
____________________________________ ________________________
Signature Date
1
____________________________________
INVESTOR NO. 2 (print name above)
____________________________________
Street (residence address)
____________________________________
City State Zip
____________________________________
Home Phone
____________________________________
Social Security Number
____________________________________
Date of Birth
____________________________________ __________________
Signature Date
2. ENTITY
[_] Corporation (authorized agent of corporation must sign)
[_] Existing Partnership (at least one partner must sign)
__________________________________________
Name of Corporation or Partnership
__________________________________________
Street (business address)
__________________________________________
City State Zip
__________________________________________
Authorized Agent (print name above)
__________________________________________
Title of Authorized Agent
__________________________________________
Federal Tax I.D. Number
__________________________________________
Business Phone
The undersigned acknowledges under the penalties of perjury that the foregoing
information is true, accurate and complete.
__________________________________________ _________________
Signature of Authorized Agent Date
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3. TRUST
[_] Trust (all trustees must sign)
________________________________________________
Trustee (print name above)
________________________________________________
Street Address
________________________________________________
City State Zip
________________________________________________
Trust (print name above)
________________________________________________
Date of Trust Agreement
________________________________________________
Social Security or Federal Identification Number
________________________________________________
Phone
The undersigned acknowledges under the penalties of perjury that the foregoing
information is true, accurate and complete.
_________________________________________ ________________
Signature Date
_________________________________________ ________________
Signature Date
ACCEPTED BY: MSH ENTERTAINMENT CORPORATION
By: ___________________________________ Date: ________________________
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