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Account Form
Share Price: $8 / share Date/Time of Trading: 4/20/2008 6:38:06 PM
Note: You will receive the current share value at the time your account is processed.
Print and complete the form below.
Indicate: ____New Account
____ Buying additional shares
Investment
Amount to invest =
Processing fee = $15.00 (non
refundable)
Amount Enclosed =_______
New
Shareholder Information
Name:___________________________________________
Address:___________________________________________
city:_________________ state: ________Zip:_________
Phone Number:__________________________________
email address:__________________________________ (required)
Select a password for your account. Use name or
numbers you can remember. After establishing your account, you will be able to view it from our
website at:
www.LottoStockMarket.com
using your email address and password.
Account Password:_______________ (Required) Make a name of 10 or less characters/digits
Service
Agreement. Very important. Be sure to read carefully.
I
have read and accepted the terms and conditions
associated
with LottoStockMarket.
Sign:___________________date____________
Enclose
check or money order and mail this form to:
Click here for contact information
For
office use only
Amount invested share value Shares
Amount invested:_____________ / _________ =
__________
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