Published on November 24, 2003
Exhibit 10.4
SUBSCRIPTION AGREEMENT
Corporate Road Show.Com Inc.
80 Orville Drive
Suite 100
Bohemia, New York 11716
Gentlemen:
The undersigned ("Subscriber") desires to become a shareholder in
Corporate Road Show.Com Inc., a New York corporation ("Company"), and hereby
subscribes for __________ shares of the Company's common stock, $0.0001 par
value (collectively, "Shares"), which are more fully described in the Company's
prospectus dated [_______], 2003 ("Prospectus"), upon the terms and conditions
set forth below.
1. The Subscriber hereby delivers a check drawn to the order of the
Company in the amount of $__________, which the undersigned agrees to contribute
to the capital of the Company, representing the aggregate purchase price of the
Shares subscribed for above at the subscription price of $1.00 per share. The
Undersigned acknowledges that this Agreement is contingent in whole or in part
on the Company's acceptance of this Agreement.
2. The Undersigned acknowledges and represents as follows:
(a) That the Undersigned has received the Prospectus; and
(b) That the Undersigned is able to bear the economic risk of
the investment in the Shares.
3. The Undersigned represents and warrants that he is a bona fide
resident of, and is domiciled in, the State of ___________ and that the Shares
are being purchased solely for the beneficial interest of the Undersigned.
4. The Undersigned is informed of the significance to you of the
foregoing representations and they are made with the intention that you will
rely upon them.
5. The Shares are to be owned and should be registered as follows
(please print):
Names ____________________________________________________________
( ) (a) A single person ( ) (b) Husband and wife, as tenants in the entirety ( )
(c) Joint Tenants ( ) (d) Tenants in Common ( ) (e) A married (man)(woman) as
(his)(her) separate property ( ) (f) Corporation ( ) (g) Trust:
(1) Trustee(s) _________________________________________________
(2) Trust date _________________________________________________
(3) Name of Trust ______________________________________________
(4) For the benefit of _________________________________________
( ) (h) Custodian:
A custodian for _____________________________________________________
under the Uniform Gift to Minors Act of the State of
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( ) (i) Other _____________________________________________________________
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(please explain)
In order to facilitate processing of your subscription, please be sure you have
completed each of the following:
A. Check made out to "Corporate Road Show.Com Inc."
B. Enter number of Shares and total cash contribution on this
Subscription Agreement, and make sure you check the correct
form of ownership in Section 5 above.
C. In Section 3 above, enter the state in which you are a legal
resident.
D. If the securities are to be owned in the name of more than one
person, each co-owner must sign.
I declare that the foregoing is true and correct.
Dated: ___________________, 200__.
X_____________________________________
- -
Signature of "Subscriber" (see Note D above)
Current residence address of Subscriber: __________________________________
_____________________________________________ Zip Code ____________________
Mailing address (if different) ____________________________________________
Social Security or Taxpayer I.D. No. ______________________________________
Telephone number: (______) ________________________________________________
X ___________________________________________
- --
Signature of "Co-Subscriber" (see Note D above)
Current residence address of Co-Subscriber: _______________________________
_____________________________________________ Zip Code ____________________
Mailing address (if different) ____________________________________________
Social Security or Taxpayer I.D. No. ______________________________________
Telephone number: (______) ________________________________________________
FOR COMPANY USE ONLY:
Fund and subscription accepted:
CORPORATE ROAD SHOW.COM INC.
By: /s/ Frank Ferraro
Frank Ferraro, President
Date: ______________________________