Exhibit 10.1
Subscription Agreement
First United States Corporation
0000 Xxxxxxxxx Xxxxx
Xxxxxxx, Xxxxxxx 00000
Attn: Xxxxxxx Xxxxx, Chairman and Chief Executive Officer
Re: Prospectus, dated __________, 2003
Dear Xx. Xxxxx:
The undersigned investor ("Investor") in this Subscription Agreement
("Agreement") hereby acknowledges receipt of the prospectus ("Prospectus"),
dated ___________, 2003, of First United States Corporation ("UNITED STATES"), a
Delaware corporation, and subscribes for the following number of units upon the
terms and conditions set forth in the Prospectus. The Investor agrees that this
Agreement is subject to acceptance by UNITED STATES, to availability and to
certain other conditions.
The Investor hereby subscribes for _______ units of UNITED STATES'
securities at $5.25 per unit, for an aggregate purchase price of $____________.
Enclosed is the Investor's check made payable to the "Xxxxx Bank, N.A./First
United States Corporation Escrow Account" and has been forwarded to the escrow
account in the self-addressed stamped envelope that has been provided for
convenience. The Investor may also elect to submit his subscription funds to the
escrow account VIA wire transfer as provided in this Agreement.
ACCEPTED AND AGREED:
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Signature of Investor
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Print Full Name
Subscription Agreement
Page 2
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Street Address
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City, State, Zip
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Area Code and Telephone Number
ACCEPTED AND AGREED:
FIRST UNITED STATES CORPORATION
By: ____________________________
Xxxxxxx Xxxxx
Chairman of the Board
WIRING INSTRUCTIONS:
First United States Corporation Escrow Account
Xxxxx Bank, N.A.
Xxxxxxxxxx, X.X. 00000
ABA No. 000000000
Account No. 00-000-000
