EXHIBIT 99.27 SUBSCRIPTION AGREEMENT
AUTOFUND SERVICING, INC.
SUBSCRIPTION AGREEMENT
Gentlemen:
The Investor named below, by payment of the purchase price for such Preferred
Shares, by the delivery of a check payable to AutoFund Servicing, Inc., hereby
subscribes for the purchase of the number of Preferred Shares indicated below of
AutoFund Servicing, Inc., at a purchase of $1.64 per Share as set forth in the
Prospectus.
Following is a brief summary of this offering:
PREFERRED SHARES
Securities being offered Up to 1,000,000 shares of convertible
preferred stock, par value $0.001.
Convertible The preferred shares are convertible one (1)
preferred share for two (2) common shares
any time after twelve months of purchase and
automatically on its thirty-six month
anniversary.
Offering price per share $1.64
Offering period The shares are being offered for a period
not to exceed two years.
Use of proceeds We will use the proceeds to purchase auto
loan accounts for collection and working
capital.
There is no minimum number of shares that we have to sell. There will be no
escrow account. All money received from the offering will be immediately used by
us and there will be no refunds. The minimum number of shares that you can
purchase is 1,000.
By payment, the named Investor further acknowledges receipt of the Prospectus
and the Subscription Agreement, the terms of which govern the investment in the
Preferred Shares being subscribed for hereby.
A. INVESTMENT: (1) Number of Shares ____________________________________
(The minimum number of shares that you can purchase is
1,000.)
(2) Total Contribution ($1.64/Share) $___________________
(3) Date of Investor's check ____________________________
B. REGISTRATION:
(1) Registered owner: __________________________________
(2) Co-Owner: ___________________________________________
(3) Mailing address: ____________________________________
City, State & zip: __________________________________
(4) Residence Address (if different from above):
Address: ____________________________________________
City, State & zip: __________________________________
(5) Birth Date: ______/______/______
(6) Employee or Affiliate: Yes ______ No ______
(7) Social Security: #: ______/______/______
(8) U.S. Citizen [ ] Other [ ]
(9) Co-Owner Social Security:#: ______/______/______
(10) Co-Owner U.S. Citizen [ ] Other [ ]
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(11) Corporate or Custodial: Taxpayer ID #: ____/___/____
(12) U.S. Citizen [ ] Other [ ]
(13) Telephone (H) ( ____________ ) ___________________
C. OWNERSHIP:
[ ] Individual Ownership [ ] XXX or Xxxxx
[ ] Joint Tenants with Rights of Survivorship
[ ] Trust/Date Trust Established_______________
[ ] Pension/Trust (S.E.P.)
[ ] Tenants in Preferred [ ] Tenants by the
Entirety
[ ] Corporate Ownership [ ] Partnership
[ ] Other __________________________________________
D. SIGNATURES: By signing below, I/we represent that I/we meet the
suitability standards set forth in the prospectus.
Registered Owner: ______________________________________
Co-Owner: ______________________________________
Print Name of Custodian or Trustee: _____________________________
Authorized Signature: ______________________________________
Date: _____________________
Signature: ___________________________________
MAIL TO:
AutoFund Servicing, Inc.
C/O Xx. Xxx Xxxxxxx, President
0000 Xxxxxx Xxxxx Xx., Xxxxx 000
Xxx Xxxxxxx, XX 00000
Telephone (000) 000-0000
Facsimile (000) 000-0000
................................................................................
FOR OFFICE USE ONLY:
Date Received: ________________________________________________
Date Accepted/Rejected _______________________________________
Subscriber's Check Amount: ____________________________________
Check No. ___________________ Date Check ________________
Deposited ________________________________
MR #________________
_____________________________________
_____________________________________
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No dealer, salesperson or any other person is authorized to give any information
or to make any representations in connection with this prospectus and, if given
or made, such information or representations must not be relied upon as having
been authorized by us. This prospectus does not constitute an offer to sell or a
solicitation of an offer to buy any security other than the securities offered
by this prospectus, or an offer to sell or solicitation of an offer to buy any
securities by anyone in any jurisdiction in which such offer or solicitation is
not authorized or is unlawful. The delivery of this prospectus shall not, under
any circumstances, create any implication that the information herein is correct
as of any time subsequent to the date of the prospectus.
AUTOFUND SERVICING, INC.
1,000,000 SHARES
PREFERREDSTOCK
$1.64 PER SHARE
PROSPECTUS
AutoFund Servicing, Inc.
0000 Xxxxxx Xxxxx Xx., Xxxxx 000
Xxx Xxxxxxx, XX 00000
Telephone (000) 000-0000
Facsimile (000) 000-0000
Effective date __________________________________
Prospectus # _____________________________________
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