Exhibit 1.3
PURCHASE AGREEMENT FOR SHARES OF
COMMON STOCK (For assistance in filling out this
form, please see the reverse side)
Mail Completed Form to: Cornerstone Ministries Investments, Inc.,
Investor Services
0000 Xxxxxxx Xxxxxxx, Xxxxx 000, Xxxxxxx, XX 00000
Please issue shares of the common stock of Cornerstone Ministries
Investments, Inc. in the amount and name shown below. I have received the
Prospectus. I certify (i) that the number shown on this form is my correct
taxpayer identification number, and (ii) that I am not subject to backup
withholding.
Signature:___________________________________________ Date__________________
Signature: __________________________________________ Date__________________
Enclosed is payment for purchase of ________ shares of common stock, at $10.00
per share $ __________
Make checks payable to: Cornerstone Ministries Investments, Inc.
Register the shares in the following name(s):
Name(1) ____________________________ Social Security or Taxpayer ID Number_______________
Birthdate___________________________
Name (2)____________________________ Social Security or Taxpayer ID number_______________
As (check one): Individual _____ Joint Tenants _____ Custodial (shares owned by minors) _____
Tenants in Common _____ Corporation _____ Trust _______ Other _____
RETIREMENT ACCOUNT ( ) Traditional XXX ( ) Xxxx XXX ( ) XXXXX
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Custodian:__________________________________
Mailing Address for the person(s) who will be registered shareowner(s):
Address:
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City, State & Zip Code: e-mail address:
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Telephone Number: Business: ( ) Home: ( )
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Yes, I want to save the cost of printing and mailing financial reports,
proxy statements, and other documents. Please send all shareowner communications
to my email address.
Signature: __________________________________
Please attach any special mailing instructions other than shown above
NO SUBSCRIPTION IS EFFECTIVE UNTIL
ACCEPTANCE You will be mailed a signed copy of this
agreement to retain for your records.
Subscription accepted by Cornerstone Ministries Investments, Inc. and
its sales representative:
____________________________________ Date__________________
Broker/Dealer_______________________________________
Broker______________________________________________
Share Purchase Agreement page 2
How to Complete the Share Purchase Agreement
Make checks payable to: Cornerstone Ministries Investments, Inc.
How can I purchase a shares? Personal check, bank check, or money orders are the
only acceptable forms of payment. No cash or credit cards are accepted.
Who should sign it? The person who is making the decision to buy the shares.
This may be different from the person in whose name the certificate is being
registered.
Whose check can be used for payment? It should be either an account in the name
of the person signing this purchase agreement or the name(s) in which the shares
are to be registered. We can not, for instance, accept a check on a corporate
bank account, where the registered shareowner is to be an individual--unless
there is an accompanying certified corporate resolution authorizing the use of
corporate funds for that purpose.
Can I buy shares for more than one person on the same form? No. Make a copy of
the form to use for an additional investment.
How can I buy shares for a person who is under 18 years old? There are Uniform
Gift to Minors Acts in the states. The "Custodial" box can be checked and the
shares can be registered in a form like: "Xxxx Xxx, as custodian for Minor Doe,
under UGMA." The effect is that Xxxx Xxx can sell the shares, receive dividends
and otherwise manage the investment, until Minor Doe becomes 18. Then, Xxxx Xxx
can request a replacement certificate in Minor Doe's name. If you want some
other legal arrangement, such as holding the shares until the minor is older
than 18, you would have to create a trust agreement, using a lawyer or a
do-it-yourself guide. You would then check the "Trust" box and fill in the name
something like: "Xxxx Xxx, trustee for Minor Doe," or "Xxxx Xxx, Trustee under
Trust Agreement dated November 29, 1997."
Can I purchase shares for an XXX or other retirement account? If your trust
agreement permits it--that's between the investors and their trustees. If your
trust agreement does not permit it (many brokerage, mutual fund or bank trustees
will not permit it), then you may choose to "roll over" or open a new account
with another trustee. The check needs to be from the trustee. You would check
"Trust" on the form and write in something like: "ABC Company, trustee for Xxxx
Xxx XXX."
Guide to registering investments Joint Tenants: The shares are jointly owned by
two or more persons. If one person passes away, all of the shares are
transferred to the surviving partner(s).
Tenants In Common: The shares are jointly owned by two or more persons. If one
person passes away, half (or whatever fraction designated of the shares)
automatically goes to the deceased's estate and not to the surviving
partner(s).
Trust: If you have an established Trust for yourself, Family or Children. Please
be sure to include exact name of the Trust and the Trust's taxpayer ID
number.
Custodial: Usually established for a minor, for a Guardian to maintain control
of the shares until the minor becomes of legal age (18). Registration
should read as follows: Xxxx Xxx as Custodian for Minor Doe under UGMA.
Make sure to list the minor's social security number, not yours.
Other: 1) Partnership - Make sure to list Tax ID #
2) XXX (Xxxxx, SEP or other retirement plan): Make sure your trust
agreement allows for investments of this kind, check with your plan
administrator. If not, you can establish a new XXX. Registration for all IRA's
should read as follows: [(Trustee or name of Plan) as Trustee for Xxxx Xxxxx XXX
Account # _________]
