Form of Securities Purchase Agreement

EX-10.1 7 ex10-1.htm SUBSCRIPTION FORM ex10-1.htm

Exhibit 10.1

SUBSCRIPTION FORM FOR OTHER THAN INDIVIDUAL

Purchasers of shares of Silver Star Capital Holdings, Inc., other than individuals, must complete this form for the proper entity that will hold title to the shares. Send this completed subscription agreement along with a wire transfer, check or money order for their total payment, payable only to:

SILVER STAR CAPITAL HOLDINGS, INC

2731 Silver Star Road

Suite 200

Orlando, Florida ###-###-####

If and when accepted by us, this subscription agreement shall constitute a subscription for shares of our common stock .. An accepted copy of this agreement will be returned to you as your receipt, and certificates for your stock will be issued to you shortly thereafter.

Method of payment: [ ] Check, [ ] Money Order, [ ] Wire Transfer

payable only to: “Silver Star Capital Holdings, Inc.”

Wire Transfer Instructions:

Bank: Bank of America

Address: Orlando, Florida

ABA: XXXXXXXXX

Account Name: Silver Star Capital Holdings, Inc.

Account Number: XXXX XXXX XXXX

Reference: Silver Star Capital Investors, LLC

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 $ _________________ for the shares subscribed.

In connection with this investment, I represent and warrant as follows:

(a) Prior to tendering payment for the shares, I received your final prospectus dated ____________________.

(b) Our entity is domiciled in the state of ______________.

ENTITY:		CORPORATION (authorized agent of the corporation must sign)
		EXISTING PARTNERSHIP (at least one partner must sign)
		TRUST (all trustees must sign)


Name of Entity


Authorized Agent (print name above)


Title of Authorized Agent


Authorized Agent (print name above)


Street (business address ) or address of Registered Agent


City, State, Zip Code


Business Telephone or Home Telephone of Registered Agent


Fax	E-mail

The undersigned acknowledges that the foregoing information is true, accurate, and complete.


		Date:

For a Trust, all Trustees must sign. Add a line for each.

ACCEPTED BY : Silver Star Capital Holdings, Inc


		Date