SPORTSMAN'S WHOLESALE COMPANY
SUBSCRIPTION AGREEMENT
FOR PURCHASERS OF SHARES OF COMMON STOCK
CASHIER'S CHECKS MUST BE MADE PAYABLE TO: A. XXXXXX XXXXXX, ESCROW AGENT
FOR SPORTSMAN'S WHOLESALE
COMPANY
FOR XXX OR PENSION INVESTORS: INCLUDE BANK CUSTODIAL DOCUMENTS
ALL CHECKS AND DOCUMENTS MUST BE DELIVERED TO: A. XXXXXX XXXXXX, ESCROW AGENT
XXX XXXXXXX & XXXXXXX
7TH FLOOR
00 XXXXX XXXX XXXXXX
XXXX XXXX XXXX, XXXX 00000
1. SHARES PURCHASED:
This subscription is for __________ SHARES in the total purchase amount
of $______________, to be registered as follows:
2. FORM OF OWNERSHIP: Xxxx only one box:
|_| SINGLE PERSON--one signature required
|_| JOINT TENANTS WITH RIGHT OF SURVIVORSHIP--all parties must sign
|_| HUSBAND AND WIFE, AS COMMUNITY PROPERTY--two signatures required
|_| TENANTS IN COMMON--all parties must sign
|_| CORPORATION
|_| CUSTODIAN UGTM--custodian signature required
|_| MARRIED PERSON/SEPARATE PROPERTY--one signature required
|_| TRUST--trustee signature(s) required. ALL SECTIONS MUST BE FILLED IN
Print Trustee name(s) (sign in Signature Section)
Trust Date | | | | | | | | |
Month Day Year
For the benefit of: ________________________________
|_| TENANTS BY THE ENTIRETIES--two signatures required
|_| PARTNERSHIP
|_| CUSTODIAN (for Taxable Person)--custodian signature required
3. INVESTOR INFORMATION: Please print name(s) in which Notes are to be
registered. All interest and principal payments and correspondence will
go to this address unless another address is listed in Section 4.
Name (1st)| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Name (2nd)| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Address | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
City | | | | | | | | | | | | | || | | | | | State | | | Zip Code | | | | | | |
Daytime Phone Number | | | |-| | | |-| | | | |
State of Residence | | | How Long? Since | | | | |
Enter the Taxpayer identification number in the appropriate box. Note:
If the account is in more than one name, the number should be that of
the first person listed.
Social Security No. | | | |-| | |-| | | | | and/or
Taxpayer Identification No. | | |-| | | | | |
| | |-| | |-| | | $| | | | | | | | $| | | | | | | | | | | M | | F Date of Birth
Gross Income for Estimated Net Worth Sex
Past 12 Months as of This Date
If Subscription is a trust, date of trust formation | | |-| | |-| | |
4. OTHER MAILING ADDRESS: If you want shareholder mailings sent to an
address other than in Section 3, please fill in below (REQUIRED FOR XXX
OR PENSION ACCOUNTS).
Account Number | | |-| | | | | | |
Name of Custodian | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Address | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
City | | | | | | | | | | | | | || | | | | | State | | | Zip Code | | | | | | |
5. SIGNATURES:
The undersigned Investor, hereby certifies that a current copy of the
Sportsman's Wholesale Company Prospectus dated October , 1998 has been
delivered to, and received by the Investor prior to making any
investment decision, and the Investor has had a full opportunity to ask
questions of, and receive information responsive to his questions from,
Sportsman's Wholesale Company prior to investing in the Shares.
NOT TO BE EXECUTED UNTIL
RECEIPT OF PROSPECTUS
X ________________________________ __/__/__
Authorized Signature of Investor Date
X ___________________________________ __/__/__
Signature of Joint Investor (if any) Date
